Achieving best possible cancer treatment outcomes in care pathways through benchmarking: ABC benchmarking.

Abstract

268 Background: Care pathways are used to manage quality in healthcare and concern the organization and standardization of care processes. By benchmarking care pathways, new knowledge is generated that can be utilized to optimize care pathways. A recent development in healthcare is the transformation from volume-based healthcare to value-based healthcare, which amongst others emphasizes the need for IPU (Integrated Practice Unit) development. The ABC-Benchmarking project is an international benchmarking project aiming to further develop the BENCH-CAN pathway benchmark, establish comparative scores on IPU development, and link outcome data to benchmark results. Methods: The 13 step benchmarking process as developed by Van Lent et al. was used. Indicators were primarily derived from the BENCH-CAN pathway benchmark format and secondary from expert opinion. An adapted Delphi method, in which clinical experts on breast and prostate cancer provided feedback in three rounds, was used to select the final set of indicators. The indicator sets containing structure, process and outcome indicators were piloted in 5 centers. Clinical outcome indicators were collected primarily through cancer registries. Site visits were performed to clarify additional questions based on the provided data and to grasp the context of the care pathway. Results: The final set contained 79 indicators for breast and 69 indicators for prostate cancer. Due to differences in registration and data availability of cancer registries not all data could be collected for all centers. Differences between cancer centers were found for example in the measurement of patient reported outcomes and status of the IPU. Aggregated and comparative data can be shown during the symposium. Conclusions: Further validating the pathway benchmark tool and adding more focus to IPU development and outcome indicators led to new knowledge on adding value for cancer patients. Examples given were optimizing care organized in care pathways for breast and prostate cancer patients. The results provided improvement opportunities for all centers. A study into patient involvement in pathway development, evaluation and improvement is also part of this project.