title: Improved Breast Cancer Care Quality Metrics After Implementation of a Standardized Tumor Board Documentation Template.
abstract: OBJECTIVE
  Cancer treatment requires a coordinated multidisciplinary treatment approach, which led to the development of the Rapid Quality Reporting System by the Commission on Cancer. However, the lack of immediate availability of documented treatment plans and the inefficiency of global medical record reviews represent significant barriers to adherence reporting and the timely implementation of quality improvement measures.
  
  
  METHODS
  Adherence to national guidelines in the areas of radiation treatment, chemotherapy, and hormone therapy was assessed after breast conservation surgery (BCS). Adherence rates within 1 year of BCS were analyzed 10 weeks before and after the implementation of a standardized documentation template at weekly multidisciplinary breast cancer conferences.
  
  
  RESULTS
  Documented adherence rates increased postimplementation in patients undergoing consideration for both radiation treatment and hormone therapy within 1 year of BCS (89% v 65%; P = .045% and 85% v 62%; P = .002, respectively). No change was observed in patients undergoing evaluation for cytotoxic chemotherapy (80% v 85%; P = 1.00).
  
  
  CONCLUSIONS
  The addition of a documentation template to multidisciplinary breast cancer conferences resulted in increased recorded adherence rates to national guidelines. This template provided a means of both accurate and efficient documentation of evidence-based practice, which represents a concept with broad application in quality improvement. Although evaluation of the project was not continued beyond the pilot stage, current quality measure scores remain within the same range.
authors.affiliation: University of Florida, Gainesville, FL.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Farrugia
authors.affiliation: University of Florida, Gainesville, FL.
authors.forename: Trevan D
authors.initials: TD
authors.lastname: Fischer
authors.affiliation: University of Florida, Gainesville, FL.
authors.forename: Daniel
authors.initials: D
authors.lastname: Delitto
authors.affiliation: University of Florida, Gainesville, FL.
authors.forename: Lisa R P
authors.initials: LR
authors.lastname: Spiguel
authors.affiliation: University of Florida, Gainesville, FL christiana.shaw@surgery.ufl.edu.
authors.forename: Christiana M
authors.initials: CM
authors.lastname: Shaw
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D011785:Quality Assurance, Health Care; D058996:Quality Improvement