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Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit
Background In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation‐wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described. Methods Clinical and pathological char...
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| Published in: | Journal of surgical oncology 2017-03, Vol.115 (3), p.243-249 |
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| container_title | Journal of surgical oncology |
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| creator | van Bommel, Annelotte C.M. Spronk, Pauline E.R. Vrancken Peeters, Marie‐Jeanne T.F.D. Jager, Agnes Lobbes, Marc Maduro, John H. Mureau, Marc A.M. Schreuder, Kay Smorenburg, Carolien H. Verloop, Janneke Westenend, Pieter J. Wouters, Michel W.J.M. Siesling, Sabine Tjan ‐ Heijnen, Vivianne C.G. van Dalen, Thijs |
| description | Background
In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation‐wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described.
Methods
Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands. Thirty‐two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals.
Results
The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre‐ and post‐operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast‐conserving surgery for invasive cancer requiring re‐operation were consistently low (∼5%). Other indicators, for example, the use of an MRI‐scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation.
Conclusions
Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. J. Surg. Oncol. 2017;115:243–249. © 2016 Wiley Periodicals, Inc. |
| doi_str_mv | 10.1002/jso.24516 |
| format | article |
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In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation‐wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described.
Methods
Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands. Thirty‐two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals.
Results
The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre‐ and post‐operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast‐conserving surgery for invasive cancer requiring re‐operation were consistently low (∼5%). Other indicators, for example, the use of an MRI‐scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation.
Conclusions
Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. J. Surg. Oncol. 2017;115:243–249. © 2016 Wiley Periodicals, Inc.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.24516</identifier><identifier>PMID: 27885679</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; benchmark ; Breast cancer ; Breast Neoplasms - epidemiology ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Breast Neoplasms, Male - enzymology ; Breast Neoplasms, Male - pathology ; Breast Neoplasms, Male - surgery ; Cancer surgery ; Carcinoma in Situ - epidemiology ; Carcinoma in Situ - pathology ; Carcinoma in Situ - surgery ; clinical audit ; Evidence-Based Practice ; Female ; Humans ; Male ; Mastectomy ; Medical Audit - methods ; Middle Aged ; Neoplasm Invasiveness ; Netherlands - epidemiology ; Quality ; quality assurance ; Quality control ; Quality Improvement ; quality indicators ; Quality Indicators, Health Care ; Surgical Oncology - methods ; Surgical Oncology - standards ; Surgical Oncology - statistics & numerical data</subject><ispartof>Journal of surgical oncology, 2017-03, Vol.115 (3), p.243-249</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><rights>2017 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4166-d087d8a1eeb0e6a3f54b3e31b112d1699478091012388120ee7a163cf0a589b83</citedby><cites>FETCH-LOGICAL-c4166-d087d8a1eeb0e6a3f54b3e31b112d1699478091012388120ee7a163cf0a589b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27885679$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Bommel, Annelotte C.M.</creatorcontrib><creatorcontrib>Spronk, Pauline E.R.</creatorcontrib><creatorcontrib>Vrancken Peeters, Marie‐Jeanne T.F.D.</creatorcontrib><creatorcontrib>Jager, Agnes</creatorcontrib><creatorcontrib>Lobbes, Marc</creatorcontrib><creatorcontrib>Maduro, John H.</creatorcontrib><creatorcontrib>Mureau, Marc A.M.</creatorcontrib><creatorcontrib>Schreuder, Kay</creatorcontrib><creatorcontrib>Smorenburg, Carolien H.</creatorcontrib><creatorcontrib>Verloop, Janneke</creatorcontrib><creatorcontrib>Westenend, Pieter J.</creatorcontrib><creatorcontrib>Wouters, Michel W.J.M.</creatorcontrib><creatorcontrib>Siesling, Sabine</creatorcontrib><creatorcontrib>Tjan ‐ Heijnen, Vivianne C.G.</creatorcontrib><creatorcontrib>van Dalen, Thijs</creatorcontrib><creatorcontrib>NABON Breast Cancer Audit</creatorcontrib><creatorcontrib>On behalf of the NABON Breast Cancer Audit</creatorcontrib><title>Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>Background
In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation‐wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described.
Methods
Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands. Thirty‐two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals.
Results
The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre‐ and post‐operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast‐conserving surgery for invasive cancer requiring re‐operation were consistently low (∼5%). Other indicators, for example, the use of an MRI‐scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation.
Conclusions
Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. J. Surg. Oncol. 2017;115:243–249. © 2016 Wiley Periodicals, Inc.</description><subject>Aged</subject><subject>benchmark</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast Neoplasms, Male - enzymology</subject><subject>Breast Neoplasms, Male - pathology</subject><subject>Breast Neoplasms, Male - surgery</subject><subject>Cancer surgery</subject><subject>Carcinoma in Situ - epidemiology</subject><subject>Carcinoma in Situ - pathology</subject><subject>Carcinoma in Situ - surgery</subject><subject>clinical audit</subject><subject>Evidence-Based Practice</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mastectomy</subject><subject>Medical Audit - methods</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Netherlands - epidemiology</subject><subject>Quality</subject><subject>quality assurance</subject><subject>Quality control</subject><subject>Quality Improvement</subject><subject>quality indicators</subject><subject>Quality Indicators, Health Care</subject><subject>Surgical Oncology - methods</subject><subject>Surgical Oncology - standards</subject><subject>Surgical Oncology - statistics & numerical data</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9kc9u1DAQxi0EotvCgRdAlrjQQ9oZx3FsbtsVf1XtHijnyEkm4FXitHYC2mfgpfE2hQMSXDzS5998M6OPsRcIFwggLvdxvBCyQPWIrRCMygwY_Zit0p_IZGnghJ3GuAcAY5R8yk5EqXWhSrNiPze9866xPbdz6ybnv3IbufXc-TiFeSA_8W4M_G62vZsO3A23YfxO97rzvA5k48Qb6xsKqQQ6qtM34ltKb-itb-MbfpMEbyc3-jRou77abfnV0rlZOtfH4c_Yk872kZ4_1DP25d3bm82H7Hr3_uNmfZ01EpXKWtBlqy0S1UDK5l0h65xyrBFFi8oYWWowCChyrVEAUWlR5U0HttCm1vkZe734plPuZopTNbjYUJ-WpXGOFWopQeRSY0Jf_YXuxzmkK2IlMNdKKCWK_1GoNSg0KGWizheqCWOMgbrqNrjBhkOFUB1zrFKO1X2OiX354DjXA7V_yN_BJeByAX64ng7_dqo-fd4tlr8A2xulsg</recordid><startdate>20170301</startdate><enddate>20170301</enddate><creator>van Bommel, Annelotte C.M.</creator><creator>Spronk, Pauline E.R.</creator><creator>Vrancken Peeters, Marie‐Jeanne T.F.D.</creator><creator>Jager, Agnes</creator><creator>Lobbes, Marc</creator><creator>Maduro, John H.</creator><creator>Mureau, Marc A.M.</creator><creator>Schreuder, Kay</creator><creator>Smorenburg, Carolien H.</creator><creator>Verloop, Janneke</creator><creator>Westenend, Pieter J.</creator><creator>Wouters, Michel W.J.M.</creator><creator>Siesling, Sabine</creator><creator>Tjan ‐ Heijnen, Vivianne C.G.</creator><creator>van Dalen, Thijs</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20170301</creationdate><title>Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit</title><author>van Bommel, Annelotte C.M. ; Spronk, Pauline E.R. ; Vrancken Peeters, Marie‐Jeanne T.F.D. ; Jager, Agnes ; Lobbes, Marc ; Maduro, John H. ; Mureau, Marc A.M. ; Schreuder, Kay ; Smorenburg, Carolien H. ; Verloop, Janneke ; Westenend, Pieter J. ; Wouters, Michel W.J.M. ; Siesling, Sabine ; Tjan ‐ Heijnen, Vivianne C.G. ; van Dalen, Thijs</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4166-d087d8a1eeb0e6a3f54b3e31b112d1699478091012388120ee7a163cf0a589b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>benchmark</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast Neoplasms, Male - enzymology</topic><topic>Breast Neoplasms, Male - pathology</topic><topic>Breast Neoplasms, Male - surgery</topic><topic>Cancer surgery</topic><topic>Carcinoma in Situ - epidemiology</topic><topic>Carcinoma in Situ - pathology</topic><topic>Carcinoma in Situ - surgery</topic><topic>clinical audit</topic><topic>Evidence-Based Practice</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mastectomy</topic><topic>Medical Audit - methods</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Netherlands - epidemiology</topic><topic>Quality</topic><topic>quality assurance</topic><topic>Quality control</topic><topic>Quality Improvement</topic><topic>quality indicators</topic><topic>Quality Indicators, Health Care</topic><topic>Surgical Oncology - methods</topic><topic>Surgical Oncology - standards</topic><topic>Surgical Oncology - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Bommel, Annelotte C.M.</creatorcontrib><creatorcontrib>Spronk, Pauline E.R.</creatorcontrib><creatorcontrib>Vrancken Peeters, Marie‐Jeanne T.F.D.</creatorcontrib><creatorcontrib>Jager, Agnes</creatorcontrib><creatorcontrib>Lobbes, Marc</creatorcontrib><creatorcontrib>Maduro, John H.</creatorcontrib><creatorcontrib>Mureau, Marc A.M.</creatorcontrib><creatorcontrib>Schreuder, Kay</creatorcontrib><creatorcontrib>Smorenburg, Carolien H.</creatorcontrib><creatorcontrib>Verloop, Janneke</creatorcontrib><creatorcontrib>Westenend, Pieter J.</creatorcontrib><creatorcontrib>Wouters, Michel W.J.M.</creatorcontrib><creatorcontrib>Siesling, Sabine</creatorcontrib><creatorcontrib>Tjan ‐ Heijnen, Vivianne C.G.</creatorcontrib><creatorcontrib>van Dalen, Thijs</creatorcontrib><creatorcontrib>NABON Breast Cancer Audit</creatorcontrib><creatorcontrib>On behalf of the NABON Breast Cancer Audit</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Bommel, Annelotte C.M.</au><au>Spronk, Pauline E.R.</au><au>Vrancken Peeters, Marie‐Jeanne T.F.D.</au><au>Jager, Agnes</au><au>Lobbes, Marc</au><au>Maduro, John H.</au><au>Mureau, Marc A.M.</au><au>Schreuder, Kay</au><au>Smorenburg, Carolien H.</au><au>Verloop, Janneke</au><au>Westenend, Pieter J.</au><au>Wouters, Michel W.J.M.</au><au>Siesling, Sabine</au><au>Tjan ‐ Heijnen, Vivianne C.G.</au><au>van Dalen, Thijs</au><aucorp>NABON Breast Cancer Audit</aucorp><aucorp>On behalf of the NABON Breast Cancer Audit</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2017-03-01</date><risdate>2017</risdate><volume>115</volume><issue>3</issue><spage>243</spage><epage>249</epage><pages>243-249</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><abstract>Background
In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation‐wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described.
Methods
Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands. Thirty‐two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals.
Results
The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre‐ and post‐operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast‐conserving surgery for invasive cancer requiring re‐operation were consistently low (∼5%). Other indicators, for example, the use of an MRI‐scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation.
Conclusions
Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. J. Surg. Oncol. 2017;115:243–249. © 2016 Wiley Periodicals, Inc.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>27885679</pmid><doi>10.1002/jso.24516</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of surgical oncology, 2017-03, Vol.115 (3), p.243-249 |
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| language | eng |
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| source | Wiley |
| subjects | Aged benchmark Breast cancer Breast Neoplasms - epidemiology Breast Neoplasms - pathology Breast Neoplasms - surgery Breast Neoplasms, Male - enzymology Breast Neoplasms, Male - pathology Breast Neoplasms, Male - surgery Cancer surgery Carcinoma in Situ - epidemiology Carcinoma in Situ - pathology Carcinoma in Situ - surgery clinical audit Evidence-Based Practice Female Humans Male Mastectomy Medical Audit - methods Middle Aged Neoplasm Invasiveness Netherlands - epidemiology Quality quality assurance Quality control Quality Improvement quality indicators Quality Indicators, Health Care Surgical Oncology - methods Surgical Oncology - standards Surgical Oncology - statistics & numerical data |
| title | Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit |
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