Implementation of a hospital-based quality assessment program for rectal cancer.
OBJECTIVE
Quality improvement programs in Europe have had a markedly beneficial effect on the processes and outcomes of rectal cancer care. The quality of rectal cancer care in the United States is not as well understood, and scalable quality improvement programs have not been developed. The purpose of this article is to describe the implementation of a hospital-based quality assessment program for rectal cancer, targeting both community and academic hospitals.


METHODS
We recruited 10 hospitals from a surgical quality improvement organization. Nurse reviewers were trained to abstract rectal cancer data from hospital medical records, and abstracts were assessed for accuracy. We conducted two surveys to assess the training program and limitations of the data abstraction. We validated data completeness and accuracy by comparing hospital medical record and tumor registry data.


RESULTS
Nine of 10 hospitals successfully performed abstractions with ≥ 90% accuracy. Experienced nurse reviewers were challenged by the technical details in operative and pathology reports. Although most variables had less than 10% missing data, outpatient testing information was lacking from some hospitals' inpatient records. This implementation project yielded a final quality assessment program consisting of 20 medical records variables and 11 tumor registry variables.


CONCLUSIONS
An innovative program linking tumor registry data to quality-improvement data for rectal cancer quality assessment was successfully implemented in 10 hospitals. This data platform and training program can serve as a template for other organizations that are interested in assessing and improving the quality of rectal cancer care.
University of Michigan, Ann Arbor; and Munson Medical Center, Traverse City, MI Hendren@med.umich.edu.
Samantha
S
Hendren
University of Michigan, Ann Arbor; and Munson Medical Center, Traverse City, MI.
Ellen
E
McKeown
University of Michigan, Ann Arbor; and Munson Medical Center, Traverse City, MI.
Arden M
AM
Morris
University of Michigan, Ann Arbor; and Munson Medical Center, Traverse City, MI.
Sandra L
SL
Wong
University of Michigan, Ann Arbor; and Munson Medical Center, Traverse City, MI.
Mary
M
Oerline
University of Michigan, Ann Arbor; and Munson Medical Center, Traverse City, MI.
Lyndia
L
Poe
University of Michigan, Ann Arbor; and Munson Medical Center, Traverse City, MI.
Darrell A
DA
Campbell
University of Michigan, Ann Arbor; and Munson Medical Center, Traverse City, MI.
Nancy J
NJ
Birkmeyer
D006761:Hospitals / Q000592:standards; D006801:Humans; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D012004:Rectal Neoplasms / Q000628:therapy*; D012042:Registries; D011795:Surveys and Questionnaires; D014481:United States