Τίτλος:
Implementing clinical protocols in oncology: quality gaps and the
learning curve phenomenon
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: The quality improvement effort in clinical practice has
focused mostly on ‘performance quality’, i.e. on the development of
comprehensive, evidence-based guidelines. This study aimed to assess the
‘conformance quality’, i.e. the extent to which guidelines once
developed are correctly and consistently applied. It also aimed to
assess the existence of quality gaps in the treatment of certain patient
segments as defined by age or gender and to investigate methods to
improve overall conformance quality. Methods: A retrospective audit of
clinical practice in a well-defined oncology setting was undertaken and
the results compared to those obtained from prospectively applying an
internally developed clinical protocol in the same setting and using
specific tools to increase conformance quality. Results: All indicators
showed improvement after the implementation of the protocol that in many
cases reached statistical significance, while in the entire cohort
advanced age was associated ( although not significantly) with
sub-optimal delivery of care. A ‘learning curve’ phenomenon in the
implementation of quality initiatives was detected, with all indicators
improving substantially in the second part of the prospective study.
Conclusions: Clinicians should pay separate attention to the
implementation of chosen protocols and employ specific tools to increase
conformance quality in patient care.
Συγγραφείς:
Kedikoglou, S
Syrigos, K
Skalkidis, Y
Ploiarchopoulou, F and
Dessypris, N
Petridou, E
Περιοδικό:
Central European Journal of Public Health
Εκδότης:
Oxford University Press
Λέξεις-κλειδιά:
clinical protocols; implementation; learning curve; lung cancer
DOI:
10.1093/eurpub/cki013
