Aim
Develop methodology for feasibility testing of measurable clinical cancer indicators; to address the local need for transparent benchmarking across cancer service providers.
Background
Quality indicators are utilised across healthcare settings as a tool for consistently measuring quality of care. After reviewing existing literature, it was identified that a standardised methodology was critical to allow for systematic definition and testing of evidence-based clinical indicators for the purpose of local benchmarking.
Method
A literature review of existing indicators across all facets of clinical care was conducted, followed by identification of possible cancer-specific indicators and consolidation of all available definitions to inform indicator development.
Each indicator was reviewed for viability and limitations using existing available administrative datasets; including the data sources required for a numerator and denominator. Following this a more granular review was undertaken to determine the exact fields and coding structure required to calculate the numerator and denominator. Where an indicator could not be extracted from existing available data sets, derivation of a proxy measure was evaluated.
After this preliminary feasibility indicator testing, a clinical working group of cancer specialists was established. Their expert advice helped inform which indicators would provide the highest value and should be pursued further to utility testing. The group also reviewed proxy measures for clinical relevance and provided advice on where improvements could be made, including expansion of indicators to examine additional tumour streams and treatment modalities.
Results
A sound and replicable methodology developed for carrying out feasibility and utility testing against clinical indicators in cancer care.
Conclusions
Attention must be focused on the granular detail of data sources to establish reproduceable and meaningful clinical indicators to gain insights for clinical practice, change and outcomes. Data availability and feasibility of collection should be key criteria considered in the development of clinical indicators.