title: Improving quality and performance in Ontario's cancer services: lessons for constructing a learning healthcare system.
abstract: Cancer Care Ontario as a provincial agency has undergone a significant transformation in the last 10 years. This paper documents a predictable crisis of radiotherapy capacity at the turn of the millennium, creating an imperative for transformative change. This transformation occurred included a divestment of existing cancer centers to large local host hospitals while retaining service obligations through a financial, quality and performance contract. The paper documents the simultaneous introduction of quality and access measures and the creation of a continuously evolving improvement panel of metrics which underpin the performance of local centers and population-wide reporting of Cancer Control. The recent successful expansion to include renal services is referenced.
authors.forename: Terrence
authors.initials: T
authors.lastname: Sullivan
mesh_terms: D006297:Health Services Accessibility / Q000458:organization & administration / Q000592:standards; D006801:Humans; D008495:Medical Oncology / Q000458:organization & administration* / Q000592:standards; D009369:Neoplasms / Q000517:prevention & control / Q000628:therapy; D009864:Ontario; D009936:Organizational Innovation; D058996:Quality Improvement / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration / Q000592:standards; D018787:Radiation Oncology / Q000458:organization & administration / Q000592:standards; D014850:Waiting Lists