title: Development and implementation of a medical oncology quality improvement tool for a regional community oncology network: the Fox Chase Cancer Center Partners initiative.
abstract: Fox Chase Cancer Center Partners (FCCCP) is a community hospital/academic partnership consisting of 25 hospitals in the Delaware Valley. Originally created in 1986, FCCCP promotes quality community cancer care through education, quality assurance, and access to clinical trial research. An important aspect of quality assurance is a yearly medical oncology audit that benchmarks quality indicators and guidelines and provides a roadmap for quality improvement initiatives in the community oncology clinical office setting. Each year, the FCCCP team and the Partner Medical Oncologists build disease site- and stage-specific indicators based on National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Concordance with multiple indicators is assessed on 20 charts from each community practice. A report for each FCCCP medical oncology practice summarizes documentation, screening recommendations, new drug use, and research trends in a particular disease site. Descriptive statistics reflect indicators met, number of new cases seen per year, number of disease site cases from tumor registry information, and clinical trial accrual total. Education and documentation tools are provided to physicians and oncology office nursing staff. The FCCCP Clinical Operations Team, consisting of medical oncologists and oncology-certified nurses, has conducted quality audits in medical oncology offices for 7 years using NCCN-derived indicators. Successful audits comprising gastric, colorectal, and breast cancer have been the focus of recent evaluations. For the 2005 stage II/III breast cancer evaluation, mean compliance per parameter was 88%, with 15 of 16 practices achieving mean compliance greater than 80%. A large-scale quality assurance audit in a community cancer partner network is feasible. Recent evaluation of localized breast cancer shows high compliance with guidelines and identifies areas for focused education. Partnership between academic and community oncologists produces a quality review process that is broadly applicable and adaptable to changing medical knowledge.
authors.affiliation: Fox Chase Cancer Center Partners, Division of Extramural Research, Fox Chase Cancer Center, Philadelphia, Pennsylvania 19046, USA. Peg.OGrady@fccc.edu
authors.forename: Margaret A
authors.initials: MA
authors.lastname: O'Grady
authors.forename: Elena
authors.initials: E
authors.lastname: Gitelson
authors.forename: Ramona F
authors.initials: RF
authors.lastname: Swaby
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Goldstein
authors.forename: Elaine
authors.initials: E
authors.lastname: Sein
authors.forename: Patricia
authors.initials: P
authors.lastname: Keeley
authors.forename: Bonnie
authors.initials: B
authors.lastname: Miller
authors.forename: Tianyu
authors.initials: T
authors.lastname: Li
authors.forename: Alan
authors.initials: A
authors.lastname: Weinstein
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Cohen
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy; D002986:Clinical Trials as Topic; D019058:Community Networks / Q000592:standards*; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008485:Medical Audit; D008495:Medical Oncology / Q000592:standards*; D009515:New Jersey; D010349:Patient Compliance; D010414:Pennsylvania; D011785:Quality Assurance, Health Care / Q000379:methods*