“Best” Practices In Outcomes Research

ISW 2013

Helsinki, Finland

Christine Laronga MD FACSComprehensive Breast Program

H. Lee Moffitt Cancer Center

Renieri circa 1626

RembrandtCirca 1606

Quality of Care

• Institute of Medicine report (1999):– Recommended monitoring quality of

cancer care– Use a core set of quality of care

indicators• Closely related to outcomes• Easily modifiable• Provide clear guidance for quality

improvement efforts

Hewitt M. Institute of Medicine and National Research Council 1999

American Society of Clinical Oncology

• National Initiative for Cancer Care Quality (NICCQ)– Develop and validate a set of core

process quality of care indicators– 7 medical oncology groups

• Quality Oncology Practice Initiative (QOPI)– Conduct ongoing assessments of these

indicators within individual practices– 308 practice groups

J Clin Oncol 2005 Sep1; 23 (25):6233-9.J Clin Oncol 2013 Apr 10; 31(11): 1471-7.

American College of Surgeons Commission on Cancer

• 1510 cancer programs• National Cancer Data

Base - registry• 1 million new cases

annually• Primary use =

retrospective evaluation of care

National Cancer Data Base

Florida Initiative for Quality Cancer Care:Consortium 2004

Figure 1: FIQCC Consortium Figure 1: FIQCC Consortium Figure 1: FIQCC Consortium

Watson Clinic/CCC&R

Moffitt Cancer Center

Space Coast Medical Associates

FCS/Sarasota Memorial

Martin Memorial Medical CenterNorth Broward Medical Center

Ocala Oncology Center

Mayo Clinic Jacksonville

UF/Shands

Tallahassee MemorialFL Institute of Research, Medicine & Surgery

Jacobsen P. Journal of Oncology Practice 2007; 3: 60-65

Florida Initiative for Quality Cancer Care

Gray JE. Journal of Oncology Practice 2011 Jul; 7(4): 247-51

Florida Initiative for Quality Cancer Care

Performing Outcomes Research

• High quality data

• Mechanisms to feed back the information to the participating practices or hospitals

• Systems to act upon the data

• Participation of providers

• Ongoing re-assessment

Rayal MV. J Surg Oncol 2009 Jun 15; 99(8):488-90

“Best” Practices

Rapid Quality Reporting System

Commission on Cancer

• Add new standards for breast and colorectal

• Expand to other disease sites• Increase adoption of the RQRS• Expand public reporting of quality data• Partnering with the LIVESTRONG

foundation