title: Evaluating the quality of colorectal cancer care in the state of Florida: results from the Florida Initiative for Quality Cancer Care.
abstract: OBJECTIVE
  The Florida Initiative for Quality Cancer Care (FIQCC) was established to evaluate the quality of cancer care at the regional level across the state of Florida. This study assessed adherence to validated quality indicators in colorectal cancer (CRC) and the variability in adherence by practice site, volume, and patient age.
  
  
  METHODS
  The FIQCC is a consortium of 11 medical oncology practices in Florida. Medical record reviews were conducted for 507 patients diagnosed with CRC and seen as new medical oncology patients in 2006. Thirty-five indicators were evaluated individually and categorized across clinical domains and components of care.
  
  
  RESULTS
  The mean adherence for 19 of 35 individual indicators was > 85%. Pathology reports were compliant on reporting depth of tumor invasion (96%; range, 86% to 100%), grade (93%; range, 72% to 100%), and status of proximal and distal surgical resection margins (97%; range. 86% to 100%); however, documentation of lymphovascular and perineural invasion did not meet adherence standards (76%; range, 53% to 100% and 39%; range, 5% to 83%, respectively). Among patients with nonmetastatic rectal cancer, documentation of the status of surgical radial margins was consistently low across sites (42%; range, 0% to 100%; P = .19). Documentation of planned treatment regimens for adjuvant chemotherapy was noted in only 58% of eligible patients.
  
  
  CONCLUSIONS
  In this large regional initiative, we found high levels of adherence to more than half of the established quality indicators. Although the quality of care delivered within FIQCC practices seems to be high, several components of care were identified that warrant further scrutiny on both a systemic level and at individual centers.
authors.affiliation: Moffitt Cancer Center, Tampa, FL 33612, USA. erin.siegel@moffitt.org
authors.forename: Erin M
authors.initials: EM
authors.lastname: Siegel
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.forename: Mokenge
authors.initials: M
authors.lastname: Malafa
authors.forename: William
authors.initials: W
authors.lastname: Fulp
authors.forename: Michelle
authors.initials: M
authors.lastname: Fletcher
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Jesusa Corazon R
authors.initials: JC
authors.lastname: Smith
authors.forename: Richard
authors.initials: R
authors.lastname: Brown
authors.forename: Richard
authors.initials: R
authors.lastname: Levine
authors.forename: Thomas
authors.initials: T
authors.lastname: Cartwright
authors.forename: Guillermo
authors.initials: G
authors.lastname: Abesada-Terk
authors.forename: George
authors.initials: G
authors.lastname: Kim
authors.forename: Carlos
authors.initials: C
authors.lastname: Alemany
authors.forename: Douglas
authors.initials: D
authors.lastname: Faig
authors.forename: Philip
authors.initials: P
authors.lastname: Sharp
authors.forename: Merry-Jennifer
authors.initials: MJ
authors.lastname: Markham
authors.forename: David
authors.initials: D
authors.lastname: Shibata
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D005431:Florida; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000592:standards; D008875:Middle Aged; D011785:Quality Assurance, Health Care / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards; D011787:Quality of Health Care