Improvement in oncology practice performance through voluntary participation in the quality oncology practice initiative
Improvement in oncology practice performance through voluntary participation in the quality oncology practice initiative
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DOI：
10.1200/jco.2007.14.2992
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发表时间：
2008-04-10
影响因子：
45.3
通讯作者：
Simone, Joseph V.
中科院分区：
文献类型：
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作者：
Jacobson, Joseph O.;Neuss, Michael N.;Simone, Joseph V.
2006年，美国临床肿瘤学会（American Society of Clinical Oncology）的所有会员医师都可以参加肿瘤学质量实践倡议（Quality Oncology Practice Initiative，QOPI），该倡议是一项基于肿瘤学实践的自愿质量测量和改进项目。QOPI评估实践表现的一系列证据和共识为基础的过程中的措施，依靠实践来完成结构化的图表审查和提交数据，通过一个安全的基于Web的portal.MethodsThis分析集中在71个做法，参加了2006年3月和9月的数据收集（7,624图表摘要在3月和10,240在9月）。在两个集合共有的33项措施中，有5项措施密切相关，最终分析中包括28项措施。为六个不同的护理领域创建了综合评分。统计学意义进行了测试的绝对变化和相对变化（相对失败减少）的质量措施，从基线到后续和较低的四分位数和所有其他quartiles.ResultsPractice性能的个别措施之间变化18.8%和98.6%。综合得分衡量的平均整体表现从3月份的78.7%上升到9月份的82.3%（P <0.05）。改进最明显的是那些最初表现最差的做法。使用一个综合得分，绝对和相对性能的底部四分位数分别提高了27%和35%，统计上优于所有其他的。上级的做法，参加QOPI表现出自我报告的过程中的措施，表现出最大的改善，在最初表现不佳的做法。
PurposeThe Quality Oncology Practice Initiative (QOPI) became available to all American Society of Clinical Oncology member physicians in 2006 as a voluntary medical oncology practice-based quality measurement and improvement project. QOPI assesses practice performance for a series of evidence- and consensus-based process measures, relying on practices to complete structured chart reviews and submit data via a secure Web-based portal.MethodsThis analysis focused on the 71 practices that participated in both the March and September 2006 data collections (7,624 charts abstracted in March and 10,240 in September). Among 33 measures common to both collections, five measures were closely correlated, and 28 are included in the final analysis. Composite scores were created for six different domains of care. Statistical significance was tested on both absolute changes and relative changes (relative failure reduction) of quality measures from baseline to follow-up and between the lower quartile and all other quartiles.ResultsPractice performance on individual measures varied between 18.8% and 98.6%. Mean overall performance as measured by a composite score increased from 78.7% in March to 82.3% in September (P < .05). Improvement was most marked among practices originally performing in the bottom quartile. Using a composite score, the absolute and relative performance for the bottom quartile improved by 27% and 35%, respectively, statistically superior to that of all others.ConclusionPractices that participated in QOPI demonstrated improved performance in self-reported process measures, with the greatest improvement demonstrated in initially low-performing practices.