The implementation of a surgeon-directed quality improvement strategy in breast cancer surgery - 19/06/14
, Nicole Hodgson, M.D., M.Sc. a, b, Mary Ann O'Brien, Ph.D. d, Lehana Thabane, Ph.D. c, e, Sylvie Cornacchi, M.Sc. a, Angela Coates, M.Ed. a, Barbara Heller, M.D. a, b, Susan Reid, M.D. a, b, Kenneth Sanders, M.D. a, b, Marko Simunovic, M.D., M.P.H. a, b, cAbstract |
Background |
The investigators designed a sustained, surgeon-directed, iterative project to improve the quality of breast cancer surgery in south central Ontario.
Methods |
The strategy included audit and feedback of surgeon-selected quality indicators, workshops, and tailoring interviews. Workshops were held to discuss quality improvement strategies, select quality indicators, review audited results, and select interventions for subsequent implementation. Semistructured tailoring interviews were conducted to identify facilitators and barriers to improved quality. All presentations and results were disseminated to all surgeons performing breast surgery in the study region.
Results |
Forty-four surgeons performing breast surgery across 12 hospitals are involved in the project. Five workshops have been held since 2005. Surgeons' enthusiasm and involvement in the project have been positive. Interim results demonstrated that over 4 audit cycles (2006–2010), the preoperative core biopsy rate increased from 73% to 92%. The tailoring interviews indicated that 18 of 21 surgeons performed preoperative core biopsies.
Conclusions |
This project highlights the feasibility of a surgeon-directed, iterative quality improvement strategy in breast cancer surgery. Interim results demonstrate consistent improvements in a key selected quality indicator.
Le texte complet de cet article est disponible en PDF.Keywords : Breast cancer surgery, Quality indicators, Audit and feedback, Tailoring, Continuing medical education, Core biopsy
Plan
| Funding was provided by grants from the McMaster Surgical Associates and the Canadian Breast Cancer Foundation: Ontario Chapter. Initial planning workshops were supported by funding from the Juravinski Cancer Centre. Dr O'Brien is supported by postdoctoral fellowships from the Canadian Breast Cancer Foundation and Psychosocial Oncology Research Training Program. The funding sources played no role in the design, conduct, or reporting of this study. |
|
| The authors declare no conflicts of interest. |
Vol 208 - N° 1
P. 50-57 - juillet 2014 Retour au numéro
Article précédent
- Line-associated thrombosis as the major cause of hospital-acquired deep vein thromboses: an analysis from National Surgical Quality Improvement Program data and a call to reassess prophylaxis strategies
- Jeffrey S. Mino, Jesse R. Gutnick, Rosebel Monteiro, Nancy Anzlovar, Allan E. Siperstein
- Risk factors for failure of percutaneous drainage and need for reoperation following symptomatic gastrointestinal anastomotic leak
- Seth I. Felder, Galinos Barmparas, Zuri Murrell, Phillip Fleshner
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?