Developing a System to Assess the Quality of Cancer Care

Research on the quality of care throughout at least the last decade has demonstrated that increases in the knowledge of treatments with proven efficacy do not translate directly to the optimal delivery of such treatments to patients. The goal of a quality monitoring system should be to measure and report on the quality of cancer care as accurately as possible for the lowest achievable cost. The results should support and inform quality improvement efforts. The authors highlight four key features of a national quality monitoring system for cancer care, discuss each, and provide recommendations. The key features are: (1) Use of a carefully designed sampling protocol to ensure that sampled patients are representative of the population of patients with the same cancer diagnosis. (2) Procedures for protecting the privacy and confidentiality of personal information. (3) Inclusion of rigorously developed measures of the quality of cancer care that are validated and updated regularly. (4) A comprehensive and ongoing data collection protocol that relies on at least three sources of available data. Implementation of a national quality monitoring system is not a trivial undertaking. It will require substantial resources, sustained commitment by a diverse group of professional organizations, institutions that provide cancer care, registry staff, clinicians, and patients. Such a system can identify opportunities to improve care, suggest which quality improvement initiatives lead to better care, and monitor the impact of quality improvement on the outcomes for patients with cancer.