Development of quality indicators of care for patients undergoing hepatic resection for metastatic colorectal cancer using a Delphi process.
BACKGROUND
Very few quality indicators of care exist for surgical procedures. These may be used to both score the quality of care received, and as a method of improving the quality of care delivered (quality improvement initiatives).


METHODS
The goal of this study was to develop a set of evidence-based quality indicators by expert consensus for patients undergoing hepatic resection of colorectal metastases to the liver. A Delphi approach was used to develop a set of evidence-based quality indicators for patients undergoing hepatic resection of colorectal metastases to liver. A panel of experts was formed through nomination by members of the Canadian Hepatopancreaticobiliary Society (CHPBS). The Delphi process consisted of three iterations of questionnaires. During each round, the panel members were asked to score the potential indicators and suggest any new indicators.


RESULTS
A list of 70 potential indicators was generated from the literature, of which 27 achieved consensus for inclusion in the final list of quality indicators. After consolidating similar or redundant indicators, the final list had 18 quality indicators. All of the indicators in the final list were from our original literature search.


CONCLUSIONS
This Delphi process has used the best available evidence, along with a consensus methodology employing the opinion of experts in the field, to identify 18 quality indicators for patients undergoing hepatic resection for metastatic colorectal cancer. These indicators will provide a means for benchmarking quality of care among surgeons, institutions, and health regions.
Dixon
Elijah
E
University of Calgary, Department of Surgery, Calgary, Alberta, Canada. Elijah.dixon@calgaryhealthregion.ca
Armstrong
Christopher
C
Maddern
Guy
G
Sutherland
Francis
F
Hemming
Alan
A
Wei
Alice
A
Sherman
Morris
M
Moore
Malcolm
M
McKay
Andrew
A
Urbach
David
D
Labrie
Martin
M
Gordon
Lee
L
Barkun
Jeffrey
J
Lynn Quan
May
M
Dowden
Scot
S
Bigam
David
D
Gallinger
Steven
S
D015179:Colorectal Neoplasms / Q000473:pathology; D003697:Delphi Technique; D006498:Hepatectomy / Q000592:standards*; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D019984:Quality Indicators, Health Care