Clinical audit of breast cancer care at the Benavides Cancer Institute, University of Santo Tomas Manila, Philippines: Part 1, methods and tools

Abstract

Clinical audit of breast cancer care at the Benavides Cancer Institute, University of Santo Tomas Manila, Philippines: Part 1, methods and tools Teresa T Sy-Ortin,1 Michael Benedict A Mejia,1 Janine Margarita Dizon,1–3 Karen Grimmer,2 Consuelo Gonzalez-Suarez,2,3 Warren Bacorro,1 Jayson Co,1 Priscilla Caguioa,4 Clevelinda Calma,4 Eugenio Regala,4 Kathleen Baldivia,1 Rowen Yolo,5 Karl Morales,6 Josefino Sanchez,6 Ray Malilay,6 Ida Marie Tabangay-Lim,6 Jocelyn C Que,7,8 Mary Jocylyn Bautista7 1Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Espana, Manila, Philippines; 2International Centre for Allied Health Evidence, University of South Australia, Adelaide, SA, Australia; 3Centre for Health Research and Movement Science, University of Santo Tomas, Espana, Manila, Philippines; 4Section of Medical Oncology, Department of Medicine, University of Santo Tomas Hospital, Espana, Manila, Philippines; 5Department of Pathology, University of Santo Tomas Hospital, Espana, Manila, Philippines; 6Department of Surgery, University of Santo Tomas Hospital, Espana, Manila, Philippines; 7Pain Management and Palliative Care Unit, Benavides Cancer Institute, University of Santo Tomas Hospital, Espana, Manila, Philippines; 8Center for Pain Medicine, Faculty of Medicine and Surgery, University of Santo Tomas, Espana, Manila, PhilippinesOn behalf of the Benavides Cancer Institute Breast Cancer Working Group (BCIBC-WG)Background: The prevalence and incidence of breast cancer has been increasing worldwide. It has been reported that the Philippines has the highest number of cases in Asia, and breast cancer is now the leading cause of death in the country. This study protocol presents the methodological plan for a quality improvement study that will assess the current practice of breast cancer examination, diagnosis, and management at one of the leading cancer institutions in the Philippines, the University of Santo Tomas Hospital-Benavides Cancer Institute (USTH-BCI); and map with standards of care, in order to identify areas that would need improvement to facilitate best practice care for breast cancer patients.Methods: This study has been approved by the Institutional Review Board of the University of Santo Tomas Hospital. A breast cancer working group has been established (Benavides Cancer Institute Breast Cancer Working Group [BCIBC-WG]) during a 1 day meeting of cancer specialists at USTH-BCI. The meeting was facilitated by both international and local methodologists in the field of evidence-based practice and quality improvement. A quality improvement plan and a clinical audit protocol for assessing current practice were drafted during this meeting. The clinical audit of current breast cancer care will be undertaken at USTH-BCI using medical records review. Clinical indicators of outcomes were identified and typical patient journeys were mapped to develop the data collection/extraction form. The data collection forms were sent to experts for face and content validation, to ensure a valid and comprehensive collection of the data. The form was revised as needed. Three hundred and eighteen (318) breast cancer cases were seen at USTH-BCI in the year 2012, and all 318 records will be reviewed as decided by the group. A reliability procedure will be undertaken among data collectors of the study and pilot testing procedure will be undertaken to test the feasibility of the data collection methods. Data will be analyzed and reported using means and percentages as appropriate. Missing data will also be reported in order to identify strategies to ensure completeness of medical records in the future.Keywords: breast cancer, audit, quality improvement, developing countries, protocol