Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Measurement that matters: an Australian set of multidisciplinary colorectal cancer quality indicators (#331)

Candice Donnelly 1 , Michelle Or 2 , James Toh 3 4 , Nirmalan Pathma-Nathan 3 , Anna Janssen 1 , Tim Shaw 1 , Paul Harnett 4 5 6 , Kim-Lin Chiew 7 8 9 10 , Shalini Vinod 7 8 , Puma Sundaresan 2 4
  1. Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
  2. Radiation Oncology Network, Western Sydney Local Health District, Westmead, NSW, Australia
  3. Department of Surgery, Westmead Hospital, Westmead, NSW, Australia
  4. Westmead Clinical School, University of Sydney, Sydney, NSW, Australia
  5. Crown Princess Mary Cancer Centre, Western Sydney Local Health District, Westmead
  6. Sydney West Cancer Network, Western Sydney & Nepean Blue Mountains Local Health Districts, NSW, Australia
  7. Cancer Therapy Centre, Liverpool Hospital, Liverpool, NSW, Australia
  8. South Western Clinical School, University of New South Wales, Randwick, NSW, Australia
  9. Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
  10. Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD, Australia

Background: Colorectal cancer (CRC) care is complex and should be delivered by multi-disciplinary teams (MDTs). To ensure consistent high quality care, measurement to identify and rectify variations in care is essential. This requires the identification of clinically relevant, evidence-based quality indicators (QIs).

Aims: To identify a priority set of evidence-based quality indicators for measuring colorectal cancer care in Australia.

Methods: This study utilised a 2-step Delphi technique to prioritise a set of 93 evidence-based CRC QIs identified by the research team in a systematic review. Round 1 was conducted by expert workshop to ‘include/exclude’ QIs based on relevance to Australian MDTs. Round 2 was conducted by online survey to rate QIs for clinical importance against a 4-point Likert scale and provide comments. An inferential analysis was conducted to measure survey results for concordance and a thematic analysis of comments.

Results: In Round 1, workshop participants (n=12) assessed 93 QIs and produced consensus on retaining 49 QIs. In Round 2, survey participants (n=44) rated QIs and a final 25 QIs across all domains of care and disciplines were prioritised with a concordance level >80%. Approximately one third of prioritised QIs are related to surgical treatment (35%), whilst other QI domains include; diagnostic work up, neo-adjuvant and adjuvant therapy, follow-up and supportive care, and management of metastatic disease. Participants represented all MDT disciplines, predominantly surgery (32%), radiation (23%) and medical (20%) oncology, and nursing (18%), across six Australian states, with an even spread of experience level.

Conclusions: This study identified an Australian set of evidence-based CRC QIs prioritised by clinical importance. This set is unique in representation of all domains of care and disciplines involved in the patient pathway. Future work will focus on testing these QIs against a large linked databases and local datasets of routinely collected electronic medical record data.