title: Identifying indicators of colorectal cancer care coordination: a Delphi study.
abstract: OBJECTIVE
  Care coordination is an important aspect of the quality of cancer care but is difficult to evaluate due to the lack of valid and reliable measures. This study was conducted to identify a set of objective measures of colorectal cancer care coordination that could be included in a medical record audit tool.
  
  
  METHODS
  A two-stage Delphi study was conducted to gain consensus among a national panel of experts about the validity of 41 potential indicators of colorectal cancer care coordination that had been identified during a literature review. The expert panel comprised 20 members from the National Health and Medical Research Colorectal Cancer Guidelines Working Party plus representatives from cancer nursing/coordination, general practice and cancer consumers.
  
  
  RESULTS
  Consensus was reached on the validity of 15 of 41 potential indicators, including those that focused on practical aspects of communication (legibility, clarity, content and timeliness of hospital discharge letters, documentation of outcomes of multidisciplinary team meetings) and appropriateness (documentation of preoperative consultation with a stoma therapist, discussions and referrals for adjuvant therapy for appropriate patients, and treatment by an experienced colorectal surgeon). There was lack of consensus on the validity of indicators relating to access to and efficiency of services.
  
  
  CONCLUSIONS
  The study has identified a core set of measures considered to be valid indicators of colorectal cancer care coordination. A medical record audit based on these measures could be used to monitor adequacy of cancer care coordination and will complement subjective measures based on self-reported experiences of patients and carers.
authors.affiliation: Cancer Epidemiology and Cancer Services Research Group, Sydney School of Public Health, University of Sydney and Cancer Institute NSW, Sydney, New South Wales, Australia; Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, New South Wales, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Young
authors.forename: L M
authors.initials: LM
authors.lastname: Masya
authors.forename: M J
authors.initials: MJ
authors.lastname: Solomon
authors.forename: H L
authors.initials: HL
authors.lastname: Shepherd
mesh_terms: D002983:Clinical Competence / Q000592:standards; D002985:Clinical Protocols / Q000592:standards; D015179:Colorectal Neoplasms / Q000628:therapy*; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D003697:Delphi Technique; D005260:Female; D006801:Humans; D008297:Male; D063886:Patient Discharge Summaries / Q000592:standards; D017064:Process Assessment, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care
keywords: Delphi study; cancer care; cancer coordination; cancer measures; care coordination; colorectal cancer