Development of quality indicators for colorectal cancer surgery, using a 3-step modified Delphi approach

Little performance measurement has been undertaken in the area of oncology, particularly for surgery, which is a pivotal event in the continuum of cancer care. This work was conducted to develop indicators of quality for colorectal cancer surgery, using a 3-step modified Delphi approach. A multidisc...

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Bibliographic Details
Published in:Canadian Journal of Surgery 2005-12, Vol.48 (6), p.441-452
Main Authors: Gagliardi, Anna R, Simunovic, Marko, Langer, Bernard, Stern, Hartley, Brown, Adalsteinn D
Format: Article
Language:English
Subjects:
Benchmarking
Colorectal cancer
Colorectal Neoplasms - surgery
Colorectal surgery
Colorectal Surgery - standards
Consensus
Delphi method
Delphi Technique
Female
Health Care Surveys
Humans
Male
Ontario
Original
Performance evaluation
Quality
Quality Indicators, Health Care
Sensitivity and Specificity
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Summary:Little performance measurement has been undertaken in the area of oncology, particularly for surgery, which is a pivotal event in the continuum of cancer care. This work was conducted to develop indicators of quality for colorectal cancer surgery, using a 3-step modified Delphi approach. A multidisciplinary panel, comprising surgical and methodological co-chairs, 9 surgeons, a medical oncologist, a radiation oncologist, a nurse and a pathologist, reviewed potential indicators extracted from the medical literature through 2 consecutive rounds of rating followed by consensus discussion. The panel then prioritized the indicators selected in the previous 2 rounds. Of 45 possible indicators that emerged from 30 selected articles, 15 were prioritized by the panel as benchmarks for assessing the quality of surgical care. The 15 indicators represent 3 levels of measurement (provincial/regional, hospital, individual provider) across several phases of care (diagnosis, surgery, adjuvant therapy, pathology and follow-up), as well as broad measures of access and outcome. The indicators selected by the panel were more often supported by evidence than those that were discarded. This project represents a unique initiative, and the results may be applicable to colorectal cancer surgery in any jurisdiction.
ISSN:0008-428X
1488-2310