title: Adherence to guideline-recommended process measures for squamous cell carcinoma of the head and neck in Ontario: Impact of surgeon and hospital volume.
abstract: The purpose of this study was to measure adherence rates to guideline-recommended process measures in patients with head and neck cancer.
  
  
  
  A total of 5720 patients who underwent surgery for head and neck cancer in Ontario between 1993 and 2010 were identified from administrative databases. Adherence to 4 guideline-recommended processes of care was measured and stratified by hospital and physician case volume.
  
  
  
  Seventy-two percent of patients received preoperative head and neck imaging, 83% received preoperative chest imaging, 58% received preoperative multidisciplinary consultation, and 77% had appropriate follow-up visits. Higher surgeon and hospital surgical volumes were associated with higher adherence rates.
  
  
  
  Adherence rates to guideline-recommended processes of care in the surgical management of patients with head and neck cancer in Ontario were moderate and should be improved. Although adherence rates seem proportional to surgical volume, even the highest volume centers have room to improve. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1987-E1992, 2016.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Antoine
authors.initials: A
authors.lastname: Eskander
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Mt Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Monteiro
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Irish
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Gullane
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ralph
authors.initials: R
authors.lastname: Gilbert
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: de Almeida
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Dale
authors.initials: D
authors.lastname: Brown
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Mt Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Freeman
authors.affiliation: Division of General Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: David R
authors.initials: DR
authors.lastname: Urbach
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada.
authors.forename: David P
authors.initials: DP
authors.lastname: Goldstein
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D019983:Guideline Adherence; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009864:Ontario; D017064:Process Assessment, Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D066231:Surgeons
keywords: head and neck cancer; health services research; processes of care; squamous cell cancer