title: Benchmarking and audit of breast units improves quality of care.
abstract: ﻿Quality Indicators (QIs) are measures of health care quality that make use of readily available hospital inpatient administrative data. Assessment quality of care can be performed on different levels: national, regional, on a hospital basis or on an individual basis. It can be a mandatory or voluntary system. In all cases development of an adequate database for data extraction, and feedback of the findings is of paramount importance. In the present paper we performed a Medline search on "QIs and breast cancer" and "benchmarking and breast cancer care", and we have added some data from personal experience. The current data clearly show that the use of QIs for breast cancer care, regular internal and external audit of performance of breast units, and benchmarking are effective to improve quality of care. Adherence to guidelines improves markedly (particularly regarding adjuvant treatment) and there are data emerging showing that this results in a better outcome. As quality assurance benefits patients, it will be a challenge for the medical and hospital community to develop affordable quality control systems, which are not leading to excessive workload.
authors.affiliation: Breast unit, Sint Augustinus Hospital, Oosterveldlaan 24, Wilrijk, Belgium.
authors.forename: P A
authors.initials: PA
authors.lastname: van Dam
authors.affiliation: Breast unit, Sint Augustinus Hospital, Oosterveldlaan 24, Wilrijk, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Verkinderen
authors.affiliation: Breast unit, Sint Augustinus Hospital, Oosterveldlaan 24, Wilrijk, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Hauspy
authors.affiliation: Breast unit, Sint Augustinus Hospital, Oosterveldlaan 24, Wilrijk, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Vermeulen
authors.affiliation: Breast unit, Sint Augustinus Hospital, Oosterveldlaan 24, Wilrijk, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Dirix
authors.affiliation: Breast unit, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Huizing
authors.affiliation: Breast unit, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Altintas
authors.affiliation: Breast unit, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Papadimitriou
authors.affiliation: Breast unit, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Peeters
authors.affiliation: Breast unit, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium.
authors.forename: W
authors.initials: W
authors.lastname: Tjalma
keywords: Audit; benchmarking; breast cancer; chemotherapy; quality control; radiotherapy
references.citation: J Natl Cancer Inst. 2002 Jun 5;94(11):835-44
references.pmid: 12048271
references.citation: Surg Oncol Clin N Am. 2011 Jul;20(3):581-6, x
references.pmid: 21640922
references.citation: Int J Qual Health Care. 2012 Aug;24(4):411-8
references.pmid: 22597705
references.citation: Ann Surg Oncol. 2011 Jan;18(1):34-9
references.pmid: 20625838
references.citation: Eur J Cancer. 2006 Sep;42(14):2200-4
references.pmid: 16905307
references.citation: Eur J Surg Oncol. 2011 Aug;37(8):714-8
references.pmid: 21458947
references.citation: Ann Oncol. 2008 Apr;19(4):614-22
references.pmid: 18024988
references.citation: Eur J Cancer. 2010 Sep;46(13):2344-56
references.pmid: 20675120
references.citation: N Engl J Med. 2006 Mar 16;354(11):1147-56
references.pmid: 16540615
references.citation: BMC Health Serv Res. 2012 Jun 21;12:167
references.pmid: 22721001
references.citation: Onkologie. 2011;34(7):362-7
references.pmid: 21734422
references.citation: Ann Surg Oncol. 2012 Oct;19(10):3251-6
references.pmid: 22814513
references.citation: Arch Gynecol Obstet. 2012 Jun;285(6):1671-83
references.pmid: 22314433
references.citation: Cancer. 2011 Aug 1;117(15):3311-21
references.pmid: 21264846
references.citation: Breast J. 2010 May-Jun;16(3):240-4
references.pmid: 20408819
references.citation: BMC Health Serv Res. 2008 Feb 27;8:45
references.pmid: 18304315
references.citation: Tumori. 2011 Sep-Oct;97(5):559-63
references.pmid: 22158483
references.citation: Arch Pathol Lab Med. 2008 Sep;132(9):1428-31
references.pmid: 18788854
references.citation: J Oncol Pract. 2011 Jul;7(4):247-51
references.pmid: 22043190
references.citation: Breast. 2012 Jun;21(3):261-6
references.pmid: 22204930
references.citation: J Clin Oncol. 2006 Feb 1;24(4):626-34
references.pmid: 16401682
references.citation: World J Surg Oncol. 2013 Mar 16;11:70
references.pmid: 23497270
references.citation: Breast. 2012 Jun;21(3):253-60
references.pmid: 22056787
references.citation: JAMA. 2011 Oct 5;306(13):1481-2
references.pmid: 21972311
references.citation: J Am Coll Radiol. 2009 Jun;6(6):442-7
references.pmid: 19467491