[Quality management and experiences with the "cancer center"].
BACKGROUND
The goal of quality management in oncology is to achieve the best possible therapeutic outcome. Improved diagnostic methods, more sophisticated therapies in various fields of specialisation and the increased implementation of multimodal therapies have led to considerable advances in the treatment of certain tumors in recent years. However, these advances depend on an interdisciplinary approach necessitating an increased division of labour. These in turn, because of the more complex organizational requirements within hospitals, make greater demands on quality management.


METHODS
In October 1999 first steps were taken in the Klinikum rechts der Isar der TU München to organisationally integrate the various institutions involved in the treatment of patients with gastro-intestinal tumors. All the oncologic competence available was bundled in a Cancer Center thus creating the structural prerequisites for interdisciplinary quality management. A daily multidisciplinary Tumor Board, a computer-supported interdisciplinary information and communications system, an interdisciplinary Disease Management Team, an outpatients department and a study centre were all called into life.


RESULTS
By the time the outpatients department went into service in November 2001 all the other structural innovations underlying interdisciplinary quality management had already been implemented. Since October 1999 2438 patients had been presented to the Tumor Board, 74% of them with primarily curative intent.


CONCLUSIONS
The disease-oriented structure of the Cancer Center has proved worthwhile. The impact of the structure on the quality of processes and results, however, has yet to be evaluated.
Siess
M
M
Arztliche Direktion, Klinikum rechts der Isar, Technische Universität München. siess@nt1.chir.med.tu-muechen.de
Bumm
R
R
Molls
M
M
Peschel
Ch
Ch
Siewert
J R
JR
D000553:Ambulatory Care / Q000458:organization & administration; D002173:Cancer Care Facilities / Q000458:organization & administration*; D003131:Combined Modality Therapy; D005770:Gastrointestinal Neoplasms / Q000473:pathology / Q000628:therapy*; D005858:Germany; D006284:Health Plan Implementation; D006801:Humans; D009367:Neoplasm Staging; D010348:Patient Care Team / Q000458:organization & administration*; D017749:Total Quality Management / Q000458:organization & administration*