title: Certification of breast centres in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer care.
abstract: BACKGROUND
  The main study objectives were: to develop a set of requirements of comprehensive breast centres; to establish a nationwide voluntary certification programme for breast centres based on such requirements, a certified quality management system (QMS), and scheduled independent, external audits and periodic recertification; and to demonstrate the general acceptance of such a certification programme with a view to introducing similar certification programmes for other major cancers.
  
  
  METHODS
  Breast centres introduced a QMS and voluntarily participated in an external certification procedure based on guideline-derived Requirements of Breast Centres specifically developed for the application procedure, all subsequent audits and recertification. All data (numbers of pending and successful applications, sites/centre, etc.) were collected by a newly founded, independent organisation for certification of cancer services delivery. Data analysis was descriptive.
  
  
  RESULTS
  Requirements of Breast Centres were developed by the German Cancer Society (DKG), the German Society of Senology (DGS) and other relevant specialist medical societies in the form of a questionnaire comprising 185 essential items based on evidence-based guidelines and the European Society of Breast Cancer Specialists' (EUSOMA) requirements of specialist breast units. From late 2002 to mid 2008, the number of participating breast centres rose from 1 to 175. As of mid 2008, 77% of an estimated 50,000 new breast cancers in Germany were diagnosed and treated at certified breast centres, 78% of which were single-site centres.
  
  
  CONCLUSIONS
  Nationwide voluntary certification of breast centres is feasible and well accepted in Germany. Dual certification of breast centres that involves certification of breast services to guideline-derived requirements in conjunction with independent certification of a mandatory QMS can serve as a model for other multidisciplinary site-specific cancer centres.
authors: German Society of Senology, and Department of Obstetrics and Gynaecology, University of Tübingen, Tübingen, Germany. sara.brucker@med.uni-tuebingen.de
authors: Sara Y
authors: SY
authors: Brucker
authors: Michael
authors: M
authors: Bamberg
authors: Walter
authors: W
authors: Jonat
authors: Matthias W
authors: MW
authors: Beckmann
authors: Andreas
authors: A
authors: Kämmerle
authors: Rolf
authors: R
authors: Kreienberg
authors: Diethelm
authors: D
authors: Wallwiener
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis / Q000628:therapy*; D002173:Cancer Care Facilities / Q000592:standards*; D002568:Certification; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D011786:Quality Control; D011795:Surveys and Questionnaires