Adopting integrated care pathways in non-small-cell lung cancer: from theory to practice.
BACKGROUND
Integrated care pathways (ICPs) have been proposed as effective strategies for quality improvement. To date, limited data are available that detail the methodology to design an optimal care pathway for patients with non-small-cell lung cancer (NSCLC). The main aim of this study was to assess the quality of health care delivered to lung cancer patients referred to a hub university hospital.


METHODS
All professionals involved with the management of NSCLC patients, in cooperation with health care researchers, identified 11 quality indicators and associated benchmarks. These were used to estimate the quality and efficiency of health care delivered to a cohort of 175 NSCLC patients.


RESULTS
The gap between "desired" and "actual" performance has been measured by benchmarking current practice against key quality indicators. Diagnostic workup, multidisciplinary team care and medical treatment of advanced disease have emerged as areas of good performance. Conversely, the management of early-stage disease offers room for improvement, in terms of both accuracy of nodal staging and surgical timeliness.


CONCLUSIONS
Analyzing the process of caring for NSCLC patients is feasible and offers room for improvement. Acquired knowledge may be shared with hospital administrators, guide the revision of ICPs, and enable the delivery of consistent, high-quality clinical standards.
Departments of Oncology, S Maria della Misericordia University Hospital, Udine, Italy. fasola.gianpiero@aoud.sanita.fvg.it
Gianpiero
G
Fasola
Simona
S
Rizzato
Valentina
V
Merlo
Marianna
M
Aita
Tino
T
Ceschia
Francesco
F
Giacomuzzi
Emilio
E
Lugatti
Stefano
S
Meduri
Angelo
A
Morelli
Maurizio
M
Rocco
Valeria
V
Tozzi
D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care; D011859:Radiography; D012189:Retrospective Studies