Medicopolitical

16 clinical indicators to improve the quality of cancer care


The first set of indicators has been developed as a benchmark for quality in cancer care in Australia.

Backed by the Australian Council on Healthcare Standards (ACHS), the measures drawn up by a multidisciplinary expert panel including oncologists are intended to be used to drive quality improvement in cancer care services.

Introducing the items in an article in the MJA, medical oncologist Dr Eva Segalov of Monash University and co-authors said the clinical indicators were developed in response to requests from healthcare providers seeking standards for accreditation, and to help flag potential problems by identifying variations within or between health services.

“Clinical indicators can be part of a system designed to close such gaps as well as to improve outcomes for all,” they wrote.

A set of national indicators would help promote consistency between public and private healthcare providers and also across the diverse range of settings in the community and hospital-based systems for patients with cancer, they said.

The standards have been developed by a 16-member expert panel drawn from groups including Clinical Oncology Society of Australia (COSA), the Medical Oncology Group of Australia (MOGA) and the Peter MacCallum Cancer Centre  as well as representatives of radiation oncologists, pharmacists, nurses and consumer groups.

The panel started with  a set of 65 possible indicators, which were whittled down based on clinical relevance, data accessibility and collectability to a core of 16 key indicators.

They said the indicators will cover “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.The set will be regularly reviewed with the potential to add or change clinical indicators, both in response to the experience of the reporting organisations and to capture the changing landscapes of cancer care provision.”

The clinical indicators are:

  • Waiting time from histological/pathological diagnosis to treatment
  • Access to sentinel node biopsy
  • Staging information provided to new patients with cancer at this health care organisation
  • Documented evidence of treatment being overseen by a multidisciplinary team
  • Anticancer systemic treatment with a hospital-approved protocol
  • Documented individualised care plan at time of treatment
  • Patients receiving cancer therapy verified by a cancer pharmacist
  • Patients with stage III colon cancer treated with chemotherapy
  • Patients aged ≥ 65 years with stage III colon cancer treated with chemotherapy
  • 28-day unplanned readmission rate
  • 30-day mortality rate post-surgery
  • Discharge information to the general practitioner
  • Patients enrolled in clinical trials
  • Advanced cancer palliative care consultation
  • Screened for supportive care needs
  • Documentation of discussion of fertility preservation with females with cancer aged ≤ 50 years.

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