title: Assessment of "best practice" treatment patterns for a "radiation oncology community outreach group" engaged in cancer disparities outcomes.
abstract: OBJECTIVE
  Minority patients with cancer have higher recurrence rates than the general population and are more likely to be treated at community centers where the standard of care has been reported to be inferior to that at academic centers. These issues are being explored by Radiation Oncology Community Outreach Group (ROCOG), a consortium of 5 Community Radiation Oncology centers participating in a National Cancer Institute-funded Disparities Grant. As a quality assurance/quality improvement initiative, this study was undertaken to ensure that treatment was at a "best practice" level.
  
  
  METHODS
  With the use of the American College of Radiology (ACR) accreditation criteria, an initial self-evaluation was done on 10 randomly selected cases at each of 5 radiation oncology clinics for patients treated between July 2002 and December 2003. The results were analyzed and presented to the centers with recommendations for improvements in April 2004. As part of an application to the ACR for accreditation, a second self-evaluation was performed on randomly selected cases treated between July and December 2004. ACR surveyors conducted the last randomly selected case evaluation.
  
  
  RESULTS
  All centers had acceptable standards at baseline. The ROCOG average compliance rate at first evaluation was 88% vs 92% for ACR-accredited facilities. At reevaluation, the ROCOG average compliance rate was 95% vs 92% (ACR-accredited facilities). At the final evaluation, the ROCOG average compliance rate was 92% vs 90% (ACR-accredited facilities). All 5 sites received ACR accreditation.
  
  
  CONCLUSIONS
  Despite a small sample, patients served by these institutions, regardless of minority status, received radiation oncology care at or above the accepted standards. A quality assessment/quality improvement initiative using ACR accreditation to ensure that "best practice" levels led to improved standards. Accreditation is one method that could be used to support a "pay-for-performance" program.
authors: Radiation Oncology Department, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, Pennsylvania, USA.
authors: Regiane S
authors: RS
authors: de Andrade
authors: Julian W
authors: JW
authors: Proctor
authors: Susan M
authors: SM
authors: Rakfal
authors: E Day
authors: ED
authors: Werts
authors: Larry L
authors: LL
authors: Schenken
authors: Cheng B
authors: CB
authors: Saw
authors: Michael
authors: M
authors: Dougherty
authors: David
authors: D
authors: Stefanik
mesh_terms: D000068:Accreditation / Q000706:statistics & numerical data*; D019985:Benchmarking; D003159:Community-Institutional Relations; D005069:Evaluation Studies as Topic; D005260:Female; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000532:radiotherapy; D017410:Practice Guidelines as Topic / Q000592:standards*; D011785:Quality Assurance, Health Care; D018787:Radiation Oncology / Q000458:organization & administration* / Q000592:standards*; D012955:Societies, Medical / Q000592:standards; D014481:United States