title: [Quality management in oncology supported by clinical cancer registries].
abstract: Efforts in nationwide quality management for oncology have so far failed to comprehensively document all levels of care. New organizational structures such as population-based clinical cancer registries or certified organ cancer centers were supposed to solve this problem more sufficiently, but they have to be accompanied by valid trans-sectoral documentation and evaluation of clinical data. To measure feasibility and qualitative effectiveness of guideline implementation we approached this problem with a nationwide investigation from 2000 to 2011. The rate of neoadjuvant radio/chemotherapy in stage UICC II/III rectum cancer, cut-off point 80% for separating good from insufficient quality, was used as a quality indicator. The nationwide analysis indicates an increase from 45% to 70%, but only with the implementation strategy of CME. The combination of new structures, evidence-based quality indicators, organ cancer center and clinical cancer registries has shown good feasibility and seems promising.
authors.affiliation: Arbeitsgemeinschaft Deutscher Tumorzentren e.V., Berlin, Deutschland. Electronic address: monika.klinkhammer-schalke@ukr.de.
authors.forename: Monika
authors.initials: M
authors.lastname: Klinkhammer-Schalke
authors.affiliation: Tumorzentrum Regensburg e.V., Regensburg, Deutschland.
authors.forename: Michael
authors.initials: M
authors.lastname: Gerken
authors.affiliation: Arbeitsgemeinschaft Deutscher Tumorzentren e.V., Berlin, Deutschland.
authors.forename: Hagen
authors.initials: H
authors.lastname: Barlag
authors.affiliation: Landesärztekammer Brandenburg, Cottbus, Deutschland.
authors.forename: Anett
authors.initials: A
authors.lastname: Tillack
mesh_terms: D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D003131:Combined Modality Therapy / Q000639:trends; D019317:Evidence-Based Medicine / Q000458:organization & administration* / Q000639:trends*; D005544:Forecasting; D005858:Germany; D019983:Guideline Adherence; D006284:Health Plan Implementation / Q000458:organization & administration / Q000639:trends; D006801:Humans; D008495:Medical Oncology / Q000458:organization & administration* / Q000639:trends*; D009313:National Health Programs / Q000458:organization & administration* / Q000639:trends*; D009367:Neoplasm Staging; D009369:Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement / Q000458:organization & administration* / Q000639:trends*; D019984:Quality Indicators, Health Care / Q000458:organization & administration / Q000639:trends; D012042:Registries; D017749:Total Quality Management / Q000458:organization & administration* / Q000639:trends*
keywords: Clinical cancer registries; Klinische Krebsregister; Leitlinienimplementierung,; Qualitätsindikatoren; Qualitätssicherung; Versorgungsverbesserung; guideline implementation; improvement in health care systems; quality indicator