title: Development of generic quality indicators for patient-centered cancer care by using a RAND modified Delphi method.
abstract: BACKGROUND
  Despite growing attention to patient-centered care, the needs of cancer patients are not always met.
  
  
  OBJECTIVE
  Using a RAND modified Delphi method, this study aimed to systematically develop evidence-based indicators, to be used to measure the quality of patient-centered cancer care as a first step toward improvement.
  
  
  METHODS
  First, key recommendations were identified from literature and were distributed over 5 domains of patient-centered cancer care: communication, physical support, psychosocial care, after-care, and organization of care. Generic key recommendations, with best available evidence, were selected from guidelines. A multidisciplinary panel of patients and medical professionals (n = 14) rated and prioritized these recommendations in a written procedure. Subsequently, the panel discussed the recommendations at a consensus meeting.
  
  
  RESULTS
  Key recommendations were identified for communication (n = 32), physical support (n = 13), psychosocial care (n = 25), after-care (n = 11), and organization of care (n = 11). For all domains, recommendations based on high-level evidence were identified except for after-care and physical support. The panel developed 17 indicators concerning criteria for communication and informed consent, evaluation of communication skills, provision of information, examination of emotional health, appointment of a care coordinator, physical complaints, follow-up, rehabilitation, psychosocial effects of waiting times, and self-management.
  
  
  CONCLUSIONS
  A set of 17 indicators for patient-centered cancer care resulted from this study. Evidence support was available for most indicators.
  
  
  CONCLUSIONS
  This set provides an opportunity to measure and improve the quality of patient-centered cancer care. It is generic and therefore applies to many patients.
authors.affiliation: Scientific Institute for Quality of Healthcare, Department of Medical Oncology, Radboud University Nijmegen Medical Centre, the Netherlands.
authors.forename: Eleonora P M M
authors.initials: EP
authors.lastname: Uphoff
authors.forename: Lianne
authors.initials: L
authors.lastname: Wennekes
authors.forename: Cornelis J A
authors.initials: CJ
authors.lastname: Punt
authors.forename: Richard P T M
authors.initials: RP
authors.lastname: Grol
authors.forename: Hub C H
authors.initials: HC
authors.lastname: Wollersheim
authors.forename: Rosella P M G
authors.initials: RP
authors.lastname: Hermens
authors.forename: Petronella B
authors.initials: PB
authors.lastname: Ottevanger
mesh_terms: D003697:Delphi Technique; D019317:Evidence-Based Medicine; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D018802:Patient-Centered Care / Q000592:standards*; D017410:Practice Guidelines as Topic; D019984:Quality Indicators, Health Care; D016032:Randomized Controlled Trials as Topic