title: Quality of care in non-small-cell lung cancer: findings from 11 oncology practices in Florida.
abstract: BACKGROUND
  Limited data on the quality of care in non-small-cell lung cancer (NSCLC) are available. This study aims to assess the quality of care in NSCLC among 11 medical oncology practices in Florida and to explore the impact of practice volume on care.
  
  
  METHODS
  Clinical guidelines and existing indicators were reviewed, and an expert survey was conducted to identify a set of process-based quality of care indicators (QI). Medical records of new patients with NSCLC seen in 2006 were retrospectively reviewed for the adherence to these QIs.
  
  
  RESULTS
  We reviewed the compliance with a set of 11 QIs (four general and seven NSCLC specific) among 531 patients. The patient median age was 68 years; 51% were male, and 49% had advanced NSCLC. The median adherence rates to general QIs and NSCLC-specific QIs were 95% (range 69% to 99%) and 69% (range 29% to 91%), respectively. We identified three main areas of deficiencies: chemotherapy consenting (69%), brain staging for stage III NSCLC (59%), and performance status assessment for advanced stages (42%). Significant variation in the adherence rates across practice sites was observed in five of 11 QIs.
  
  
  CONCLUSIONS
  On the basis of this data set of participating institutions in Florida, several areas in the care of patients with NSCLC were identified as targets for future quality improvement efforts.
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, Tampa; Center for Cancer Care and Research, Lakeland; Florida Cancer Specialists, Sarasota; Space Coast Medical Associates, Titusville; Ocala Oncology Center, Ocala; Robert and Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Cancer Centers of Florida, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; University of Florida/Shands Cancer Center, Gainesville, FL; Karmanos Cancer Institute, Detroit, MI.
authors.forename: Tawee
authors.initials: T
authors.lastname: Tanvetyanon
authors.forename: Michelle
authors.initials: M
authors.lastname: Corman
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.forename: Fred
authors.initials: F
authors.lastname: Schreiber
authors.forename: Richard H
authors.initials: RH
authors.lastname: Brown
authors.forename: Richard M
authors.initials: RM
authors.lastname: Levine
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Cartwright
authors.forename: Guillermo
authors.initials: G
authors.lastname: Abesada-Terk
authors.forename: George P
authors.initials: GP
authors.lastname: Kim
authors.forename: Carlos
authors.initials: C
authors.lastname: Alemany
authors.forename: Douglas
authors.initials: D
authors.lastname: Faig
authors.forename: Philip V
authors.initials: PV
authors.lastname: Sharp
authors.forename: Merry-Jennifer
authors.initials: MJ
authors.lastname: Markham
authors.forename: Gerold
authors.initials: G
authors.lastname: Bepler
authors.forename: Erin
authors.initials: E
authors.lastname: Siegel
authors.forename: David
authors.initials: D
authors.lastname: Shibata
authors.forename: Mokenge
authors.initials: M
authors.lastname: Malafa
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen