Quality improvement in surgical oncology - measuring and improving clinical outcomes

Deliberate quality improvement in surgical oncology can optimize patient outcomes, by ensuring the application of current best knowledge and practice to our patients. We hypothesize that effective projects should support surgeons performing cancer operations, and avoid the prevalent tendency to focus on identifying 'bad apples' or surgeons not meeting a pre-set bar of performance. As well, the overall quality effort must be data driven. A useful framework to assist in developing a quality improvement project includes the following steps: 1) debate and select values and goals that will inform the effort; 2) select a clinical area for improvement; 3) select team members; 4) select relevant quality markers for improvement; 5) collect data for selected markers; 6) select and operationalize interventions; and, 7) re-evaluate, potentially modify, and potentially repeat the above steps. Common sense, a well thought out process, and good will, will likely lead to improvements in the outcomes of patients.