Timeliness of breast tissue pathology reports: Quality thresholds for breast centers.

Abstract

204 Background: The National Quality Measures for Breast Centers (NQMBC) was started in 2005 to provide quality metrics for breast centers. Each center enters confidential aggregate results to questions regarding the process of breast care. Each data entry can be immediately compared with all other centers. We reviewed data regarding the timeliness of pathology reports after tissue sampling to look for variation among different types of breast centers. Methods: We reviewed the following measures: 1) Time between needle/core biopsy and availability of pathology report; 2) Time between surgical biopsy and availability of pathology report; and 3) Time between initial cancer surgery and availability of pathology report. We looked for variation in results according to structural differences of breast centers. Results: There were 391 center entries reviewing over 21,000 patient encounters between 2005 and 2011. Results included percentiles at 10, 25, 50, 75, and 90 and mean value. Overall, pathology reports for needle biopsy were available much sooner (mean 1.4 days) than any surgical biopsy or excision (2.1, 2.4 days). Results were not altered according to demographic characteristics (type of center, cancer volume, financial structure, size of city and geographic location). Conclusions: The timeliness of pathology reporting of breast specimens is very consistent throughout the participating NQMBC centers, regardless of type and size of breast center. In view of the consistency of those results, a threshold level of care (10th percentile) may be identified above which all centers should be expected to perform. This minimum level of performance is called the quality threshold. Centers that do not perform above this quality threshold should be ready to explain why their performance falls below this level. Centers who surpass this quality threshold should strive for a quality goal (50th percentile). We expect that by setting both the quality threshold and the quality goal for each measurement, we will have ongoing encouragement for achievable improvement for each measure.