TY - JOUR
T1 - Clinical Auditing as an Instrument for Quality Improvement in Breast Cancer Care in the Netherlands
T2 - The National NABON Breast Cancer Audit
AU - Van Bommel, Annelotte C. M.
AU - Spronk, Pauline E. R.
AU - Peeters, Marie-Jeanne T. F. D. Vrancken
AU - Jager, Agnes
AU - Lobbes, Marc
AU - Maduro, John H.
AU - Mureau, Marc A. M.
AU - Schreuder, Kay
AU - Smorenburg, Carolien H.
AU - Verloop, Janneke
AU - Westenend, Pieter J.
AU - Wouters, Michel W. J. M.
AU - Siesling, Sabine
AU - Tjan-Heijnen, Vivianne C. G.
AU - Van Dalen, Thijs
AU - Nabon Breast Canc Audit
PY - 2017/3/1
Y1 - 2017/3/1
N2 - 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 (similar to 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. (C) 2016 Wiley Periodicals, Inc.
AB - 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 (similar to 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. (C) 2016 Wiley Periodicals, Inc.
KW - breast cancer
KW - clinical audit
KW - quality assurance
KW - quality improvement
KW - quality indicators
KW - benchmark
KW - OF-CARE
KW - INDICATORS
U2 - 10.1002/jso.24516
DO - 10.1002/jso.24516
M3 - Article
C2 - 27885679
SN - 0022-4790
VL - 115
SP - 243
EP - 249
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 3
ER -