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| European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2015 Jun 24. pii: S0748-7983(15)00489-8. doi: 10.1016/j.ejso.2015.06.006 |
| The effect of EUSOMA certification on quality of breast cancer care. |
| van Dam PA1, Tomatis M2, Marotti L3, Heil J4, Wilson R5, Rosselli Del Turco M6, Mayr C7, Costa A8, Danei M9, Denk A10, Emons G11, Friedrichs K12, Harbeck N13, Kiechle M14, Koheler U15, Kuemmel S16, Maass N17, Marth C18, Prové A19, Kimmig R20, Rageth C21, Regolo L22, Salehi L23, Sarlos D24, Singer C25, Sohn C26, Staelens G27, Tinterri C28, Ponti A29 |
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Abstract AIM OF THE STUDY: The European Society of Breast Cancer Specialists (EUSOMA) has fostered a voluntary certification process for breast units to establish minimum standards and ensure specialist multidisciplinary care. In the present study we assess the impact of EUSOMA certification for all breast units for which sufficient information was available before and after certification. MATERIALS AND METHODS: For 22 EUSOMA certified breast units data of 30,444 patients could be extracted from the EUSOMA database on the evolution of QI's before and after certification. RESULTS: On the average of all units, the minimum standard of care was achieved for 12/13 QI's before and after EUSOMA certification (not met for DCIS receiving just one operation). There was a significant improvement of 5 QI's after certification. The proportion of patients with invasive cancer undergoing an axillary clearance containing >9 lymph nodes (91.5% vs 89.4%, p 0.003) and patients with invasive cancer having just 1 operation (83.1% vs 80.4%, p < 0.001) dropped, but remained above the minimum standard. The targeted standard of breast care was reached for the same 4/13 QI's before and after EUSOMA certification. CONCLUSION: Although the absolute effect of EUSOMA certification was modest it further increases standards of care and should be regarded as part of a process aiming for excellence. Dedicated units already provide a high level of care before certification, but continuous monitoring and audit remains of paramount importance as complete adherence to guidelines is difficult to achieve. |
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Copyright © 2015 Elsevier Ltd. All rights reserved. |
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KEYWORDS: Audit, Benchmarking, Breast cancer, Chemotherapy, EUSOMA, Quality control, Radiotherapy |
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Publikations ID: 26278019 Quelle: öffnen |
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