New measures foster better cancer treatment

June 18, 2007

After more than two years of collaborative effort, national quality measures for breast and colon cancer treatment are now in place. The American College of Surgeons Commission on Cancer, working with two other professional organizations, recently received endorsement from the National Quality Forum for the first nationally recognized hospital-based performance measures for breast and colorectal cancer.

After more than two years of collaborative effort, national quality measures for breast and colon cancer treatment are now in place. The American College of Surgeons (ACoS) Commission on Cancer (CoC), working with two other professional organizations, recently received endorsement from the National Quality Forum (NQF) for the first nationally recognized hospital-based performance measures for breast and colorectal cancer.

The new NQF-endorsed measures "close the loop on quality improvement," according to the oncologists who designed them, by creating data usable by hospitals, doctors, and pharmacists to compare their performance with that of others. In seeking consensus, the CoC made "a deliberate decision to evaluate the performance of hospitals and healthcare systems, not individual physicians," said Stephen Edge, M.D., an oncologist at the Roswell Park Cancer Institute in Buffalo. He co-led the CoC Quality Integration Committee.

Development and implementation of such measures "is a tough process that must heavily involve clinical pharmacists to truly be successful," said Kamakshi Rao, Pharm.D., a University of North Carolina Hospitals and Clincs clinical pharmacist specializing in oncology. "We must strengthen the collaborative effort, working with physicians to implement the protocols to ensure compliance."

Rao noted that much of ongoing cancer care is delivered in outpatient settings. "We are an increasing presence in those settings, and as that presence grows, so do our responsibilities. Monitoring proper dosing and documentation of compliance are two explicit responsibilities," she said.

Information gathering is, in fact, vital to the success of the measures, said Andrew Stewart, senior manager, National Cancer Database (NCD). The NCD has been collecting information on stage III colon cancer treatment through its Cancer Program Practice Profile Reports (CP3R) for two years.

When data are received, they are evaluated by NCD staff, and feedback is given to the centers on improving the reporting process. That has resulted in significant improvement in CP3R reporting compliance in the past two years, raising the rate from 64.4% in January 2005 to 74.9% in May 2007.

THE AUTHOR is a writer based in Gettysburg, Pa.