title: Setting the bar: compliance with ovarian cancer quality indicators at a National Cancer Institute-designated Comprehensive Cancer Center.
abstract: OBJECTIVE
  Ovarian cancer quality measures are being developed to improve health care delivery and outcomes. Our objective is to evaluate compliance with 8 quality indicators proposed by the Society of Gynecologic Oncology.
  
  
  METHODS
  A review of 123 ovarian cancer patients who underwent primary surgical staging/cytoreduction and chemotherapy from 2010-2012 was undertaken. Medical records were reviewed, and descriptive statistics were performed to determine compliance.
  
  
  RESULTS
  A timely operative report documenting residual disease was dictated for 121/123 (98.4%) patients. Complete surgical staging was performed in 33/55 (60.0%) stage I-IIIB patients, with lymphadenectomy most frequently omitted. For optimally debulked stage III patients, 52/56 (92.9%) were offered intraperitoneal chemotherapy. Ultimately, 29/56 (51.8%) received this route and 19/56 (33.9%) within 42 days (range 18-48, median 40 days). Clinical trial randomization and co-morbidities accounted for most cases of non-compliance. All 105 patients for whom chemotherapy was indicated received platin/taxane therapy, and 79/105 (75.2%) within 42 days (range 4-82, median 37days). Venous thromboembolism prophylaxis was provided mechanically in 122/123 (99.2%) and pharmacologically in 99/123 (80.5%) patients within 24h of surgery. Prophylactic parenteral antibiotics were administered within 60 min of cytoreduction in 119/123 (96.7%) and discontinued within 24h after surgery in 120/123 (97.6%) cases.
  
  
  CONCLUSIONS
  Compliance with strict definitions of ovarian cancer quality indicators varies depending on the care delivered and documentation of that care. Increased attention to comprehensive surgical staging and timely initiation of chemotherapy appears warranted. With the move toward value-based payment models, quality indicators will play a significant role in health care delivery.
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Margaret I
authors.initials: MI
authors.lastname: Liang
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Adam C
authors.initials: AC
authors.lastname: ElNaggar
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Silpa
authors.initials: S
authors.lastname: Nekkanti
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: O'Malley
authors.affiliation: Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Erinn M
authors.initials: EM
authors.lastname: Hade
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Copeland
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Fowler
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Ritu
authors.initials: R
authors.lastname: Salani
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Floor J
authors.initials: FJ
authors.lastname: Backes
authors.affiliation: Division of Gynecologic Oncology Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA. Electronic address: David.Cohn@osumc.edu.
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008495:Medical Oncology / Q000379:methods* / Q000592:standards*; D008875:Middle Aged; D054547:National Cancer Institute (U.S.); D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D010349:Patient Compliance; D011787:Quality of Health Care; D014481:United States
keywords: Ovarian cancer; Quality indicators; Quality measures