Quality indicators in the management of bladder cancer: A modified Delphi study

Abstract Background Survival in patients with bladder cancer has only moderately improved over the past 2 decades. A potential reason for this is nonadherence to clinical guidelines and best practice, leading to wide variations in care. Common quality indicators (QIs) are needed to quantify adherenc...

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Published in:Urologic oncology 2017-06, Vol.35 (6), p.328-334
Main Authors: Khare, Satya R., M.Sc.N., M.B.A, Aprikian, Armen, M.D, Black, Peter, M.D, Blais, Normand, M.D, Booth, Chris, M.D, Brimo, Fadi, M.D, Chin, Joseph, M.D, Chung, Peter, M.D, Drachenberg, Darrel, M.D, Eapen, Libni, M.D, Fairey, Adrian, M.D, Fleshner, Neil, M.D, Fradet, Yves, M.D, Gotto, Geoffrey, M.D, Izawa, Jonathan, M.D, Jewett, Michael, M.D, Kulkarni, Girish, M.D, Lacombe, Louis, M.D, Moore, Ron, M.D, Morash, Chris, M.D, North, Scott, M.D, Rendon, Ricardo, M.D, Saad, Fred, M.D, Shayegan, Bobby, M.D, Siemens, Robert, M.D, So, Alan, M.D, Sridhar, Srikala S., M.D, Traboulsi, Samer L., M.D, Kassouf, Wassim, M.D
Format: Article
Language:English
Subjects:
Bladder cancer
Delphi Technique
Female
Humans
Male
Outcome
Quality improvement
Quality indicators
Survival Analysis
Urinary Bladder Neoplasms - mortality
Urinary Bladder Neoplasms - pathology
Urinary Bladder Neoplasms - therapy
Urology
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Summary:Abstract Background Survival in patients with bladder cancer has only moderately improved over the past 2 decades. A potential reason for this is nonadherence to clinical guidelines and best practice, leading to wide variations in care. Common quality indicators (QIs) are needed to quantify adherence to best practice and provide data for benchmarking and quality improvement. Objective To produce an evidence- and consensus-based list of QIs for the management of bladder cancer. Methods A modified Delphi method was used to develop the indicator list. Candidate indicators were extracted from the literature and rated by a 27-member Canadian expert panel in several rounds until consensus was reached on the final list of indicators. In rounds with numeric ratings, a frequency analysis was performed. Results A total of 86 indicators were rated, 52 extracted from the literature and 34 suggested by the panel. After iterative rounds of ratings and discussion, a final list of 60 QIs spanning several disciplines and phases of the cancer care continuum was developed. Conclusions This is the first study to comprehensively produce common QIs representing structure, process, and outcome measures in bladder cancer management. Though developed in Canada, these indicators can be used in other countries with slight modifications to track performance and improve care.
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2016.12.003