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- 1 Monash University, Melbourne, VIC
- 2 Monash Health, Melbourne, VIC
- 3 Princess Alexandra Hospital, Brisbane, QLD
- 4 Cancer Council Australia, Sydney, NSW
- 5 Cancer Institute NSW, Sydney, NSW
- 6 Alfred Centre, Melbourne, VIC
- 7 Epworth HealthCare, Melbourne, VIC
- 8 Peter MacCallum Cancer Centre, Melbourne, VIC
- 9 Alfred Health, Melbourne, VIC
- 10 CQM Consultants, Melbourne, VIC
- 11 Australian Council on Healthcare Standards, Sydney, NSW
- 12 University of Melbourne, Melbourne, VIC
- 13 Wimmera Cancer Centre, Wimmera Health Care Group, Horsham, VIC
- 14 University of Newcastle, Newcastle, NSW
- 15 Western Private Hospital, Melbourne, VIC
- 16 Icon Group, Brisbane, QLD
Correspondence: eva.segelov@monash.edu
Acknowledgements:
The Australian Council on Healthcare Standards provided project management and funding for travel logistics to attend the face‐to‐face meetings.
Competing interests:
No relevant disclosures.
- 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin 2020; 70: 7–30.
- 2. Rowland JH, Hewitt M, Ganz PA. Cancer survivorship: a new challenge in delivering quality cancer care. J Clin Oncol 2006; 24: 5101–5104.
- 3. Addario BJ, Fadich A, Fox J, et al. Patient value: perspectives from the advocacy community. Health Expect 2018; 21: 57–63.
- 4. Mooney K, Berry DL, Whisenant M, Sjoberg D. Improving cancer care through the patient experience: how to use patient‐reported outcomes in clinical practice. Am Soc Clin Oncol Educ Book 2017; 37: 695–704.
- 5. DeMartino JK. Measuring quality in oncology: challenges and opportunities. J Natl Compr Canc Netw 2013; 11: 1482–1491.
- 6. Garrubba M, Joseph C, Melder A, Yap G. Key performance indicators for hospital reporting: a rapid review. Melbourne: Centre for Clinical Effectiveness, Monash Health; 2016. https://monashhealth.org/wp-content/uploads/2019/03/Indicators-of-Hospital-Performance-FINAL-Aug-2016_sop.pdf (viewed Aug 2020).
- 7. Australian Council of Healthcare Standards. Clinical Indicator Program 2020. Sydney: ACHS, 2014. https://www.achs.org.au/media/80662/ach078_clinical_indicator_program_6pp_brochure_v7_film_revised.pdf (viewed Aug 2020).
- 8. Polite BN, Gluck AR, Brawley OW. Ensuring equity and justice in the care and outcomes of patients with cancer. JAMA 2019; 321: 1663–1664.
- 9. van Bommel ACM, Spronk PER, Vrancken Peeters MJTFD, et al. Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: the national NABON Breast Cancer Audit. J Surg Oncol 2017; 115: 243–249.
- 10. Kim ML, Matheson L, Garrard B, et al. Use of clinical quality indicators to improve lung cancer care in a regional/rural network of health services. Aust J Rural Health 2019; 27: 183–187.
- 11. Collopy BT. Clinical indicators in accreditation: an effective stimulus to improve patient care. Int J Qual Health Care 2000; 12: 211–216.
- 12. Segelov E, Garvey G. Cancer and Indigenous populations: time to end the disparity. JCO Glob Oncol 2020; 6: 80–82.
- 13. Khare S, Batist G, Bartlett G. Identification of performance indicators across a network of clinical cancer programs. Curr Oncol 2016; 23: 81.
- 14. Australian Council on Healthcare Standards. ACHS Performance and Outcome Service: Australasian Clinical Indicator Report (ACIR). https://www.achs.org.au/programs-services/clinical-indicator-program/acir-australasian-clinical-indicator-report/ (viewed May 2021).
- 15. Boulkedid R, Abdoul H, Loustau M, et al. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS One 2011; 6: e20476.
- 16. Mellett C, O’Donovan A, Hayes C. The development of outcome key performance indicators for systemic anti‐cancer therapy using a modified Delphi method. Eur J Cancer Care (Engl) 2020; 29: e13240.
- 17. Doolan‐Noble F, Barson S, Lyndon M, et al. Establishing gold standards for System‐Level Measures: a modified Delphi consensus process. Int J Qual Health Care 2018; 31: 205–211.
- 18. Braithwaite J, Hibbert P, Blakely B, Plumb J, Hannaford N, Long JC, Marks D. Health system frameworks and performance indicators in eight countries: A comparative international analysis. SAGE Open Med 2017; 5: 2050312116686516.
- 19. Beaussier AL, Demeritt D, Griffiths A, Rothstein H. Steering by their own lights: Why regulators across Europe use different indicators to measure healthcare quality. Health Policy 2020; 124: 501–510.
- 20. Pollitt C. Performance management 40 years on: a review. Some key decisions and consequences. Public Money Manag 2018; 38: 167–174.
- 21. Woodhouse B, Pattison S, Segelov E, et al. Consensus‐derived quality performance indicators for neuroendocrine tumour care. J Clin Med 2019; 8: 1455.
- 22. Wiles LK, Hooper TD, Hibbert PD, et al. Clinical indicators for common paediatric conditions: Processes, provenance and products of the CareTrack Kids study. PLoS One 2019; 14: e0209637.
- 23. Sampurno F, Zheng J, Di Stefano L, et al. Quality indicators for global benchmarking of localized prostate cancer management. J Urol 2018; 200: 319–326.
- 24. Hernandez‐Boussard T, Blayney DW, Brooks JD. Leveraging digital data to inform and improve quality cancer care. Cancer Epidemiol Biomarkers Prev 2020; 29: 816–822.
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Abstract
Introduction: The Australian Council on Healthcare Standards (ACHS) sponsored an expert‐led, consensus‐driven, four‐stage process, based on a modified Delphi methodology, to determine a set of clinical indicators as quality measures of cancer service provision in Australia. This was done in response to requests from institutional health care providers seeking accreditation, which were additional and complementary to the existing radiation oncology set. The steering group members comprised multidisciplinary key opinion leaders and a consumer representative. Five additional participants constituted the stakeholder group, who deliberated on the final indicator set.
Methods and recommendations: An initial meeting of the steering group scoped the high level nature of the desired set. In stage 2, 65 candidate indicators were identified by a literature review and a search of international metrics. These were ranked by survey, based on ease of data accessibility and collectability and clinical relevance. The top 27 candidates were debated by the stakeholder group and culled to a final set of 16 indicators. A user manual was created with indicators mapped to clinical codes. The indicator set was ratified by the Clinical Oncology Society of Australia and is now available for use by health care organisations participating in the ACHS Clinical Indicator Program.
This inaugural cancer clinical indicator set covers high level assessment of various critical processes in cancer service provision in Australia. Regular reviews and updates will ensure usability.
Changes in management as a result of this statement: This is the inaugural indicator set for cancer care for use across Australia and internationally under the ACHS Clinical Indicator Program. Multidisciplinary involvement through a modified Delphi process selected indicators representing both generic and specific aspects of care across the cancer journey pathway and will provide a functional tool to compare health care delivery across multiple settings. It is anticipated that this will drive continual improvement in cancer care provision.