Measuring quality of care in the treatment of colorectal cancer: the moffitt quality practice initiative.
OBJECTIVE
The Moffitt Quality Practice Initiative (MQPI) is a practice-based system of quality self-assessment, the ultimate goal of which is to improve the quality of cancer care at a statewide level. The initial phase of this project focused on developing procedures, determining feasibility, and evaluating utility for assessing quality of care for colorectal cancer within an existing affiliate network.


METHODS
Representatives from four oncology groups selected quality measures consistent with evidence-, consensus-, and safety-based guidelines that could be abstracted from medical records. Trained abstractors then reviewed records of all eligible colorectal patients seen by each practice in 2004. Frequencies of responses for each indicator were tabulated for overall and practice-specific level of adherence and were compared among practices.


RESULTS
Adherence was uniformly high for several indicators, including confirmatory pathology report, staging information, and chemotherapy discussion or recommendation. Lower adherence was evident across practices for performance of carcinoembryonic tests and complete colonoscopic evaluations. Significant variation among practices was evident only for consent for chemotherapy.


CONCLUSIONS
The initial phase of MQPI demonstrated the feasibility and utility of assessing quality indicators for colorectal cancer among members of an existing affiliate network. Findings identified areas where adherence to care was uniformly high, but also identified areas where both overall and practice-specific adherence were less than optimal. These efforts lay the groundwork for expanding MQPI in several directions that have in common the potential to improve the quality of cancer care on a statewide basis.
Jacobsen
Paul B
PB
H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Space Coast Medical Associates, Titusville, FL; Center for Cancer Care and Research, Lakeland, FL; and Sarasota Memorial Hospital, Sarasota, FL.
Shibata
David
D
Siegel
Erin M
EM
Druta
Mihaela
M
Lee
Ji-Hyun
JH
Marshburn
Jan
J
Davenport
Linda
L
Cruse
Hugh
H
Levine
Richard
R
Gondi
Avantica
A
Brown
Richard
R
Malafa
Mokenge
M