Improving Quality In Cancer Screening: The Excellence Report For Colonoscopy

描述（由申请人提供）：该计划旨在评估和提高门诊护理环境中筛查和诊断性结肠镜检查的质量。我们将使用临床结果研究倡议（科里）联盟和国家内窥镜数据库（NED）开发和测试卓越报告，这是一份胃肠道（GI）内窥镜检查质量报告卡，重点关注国家认可的结肠镜检查质量过程措施。在制定卓越报告后，我们将使用定性和定量方法对其进行评估。使用群集随机试验设计，在门诊护理中心或办公室工作的CORI附属临床医生将每月收到他们的质量指标报告沿着，并与其他科里临床医生和国家基准进行比较。将沿着对质量措施数据报告和质量建议遵守情况的影响以及报告终止后变更的持久性进行测量。同时，将对收到卓越报告的代表性临床医生样本进行现场观察和访谈。根据这些观察和访谈，将创建一项调查，并对所有参与的临床医生进行调查。我们将了解临床医生对所提供数据的可靠性和有效性的看法，他们对质量倡议的接受程度，我们将寻找对工作流程的影响以及卓越报告的任何意外后果。与此开发和评估活动同时，该计划将支持一系列GI报告软件供应商、成像系统供应商和GI病理学实验室沿着与GI专业协会一起开发可持续的基于标准的架构，以使卓越报告扩展到科里之外。

DESCRIPTION (provided by the applicant): This initiative is designed to evaluate and improve the quality of screening and diagnostic colonoscopies in ambulatory care settings. Using the Clinical Outcomes Research Initiative (CORI) consortium and the National Endoscopic Database (NED) we will develop and test the Excellence Report, a quality report card for gastrointestinal (GI) endoscopy, focusing on nationally-recognized quality process measures for colonoscopy. After development of the Excellence Report, we will evaluate it using both qualitative and quantitative methodologies. Using a clustered randomized trial design, CORI-affiliated clinicians working in ambulatory care centers or offices will receive monthly reports of their quality measures along with comparisons to other CORI clinicians and to national benchmarks. The effect both on reporting of quality measures data and on adherence to the quality recommendations will be measured along with the durability of changes upon ceasing the reports. Concurrently, field observations and interviews will be performed with a representative sample of clinicians who are receiving the Excellence Report. Based on these observations and interviews, a survey will be created and administered to all participating clinicians. We will learn about the perceptions of the clinicians of reliability and validity of the data that are presented, their acceptance of the quality initiative, and we will look for effects on workflow and for any unintended consequences of the Excellence Report. Concurrent with this development and evaluation activity, this initiative will support a workgroup of GI reporting software vendors, imaging system vendors and GI pathology laboratories along with the GI specialty societies on development of a sustainable and standards based architecture that will allow the Excellence Report to expand beyond CORI.