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VA-Radiation Oncology Quality Surveillance Program.

Michael Hagan1, Rishabh Kapoor1, Jeff Michalski2

  • 1VHA National Radiation Oncology Program Office, Richmond, Virginia.

International Journal of Radiation Oncology, Biology, Physics
|January 28, 2020
PubMed
Summary
This summary is machine-generated.

The Veterans Affairs established a radiation oncology quality surveillance program to monitor care for 15,000 veterans annually. This program uses quality measures to identify variations and improve treatment for lung and prostate cancer patients.

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Area of Science:

  • Oncology
  • Health Services Research
  • Quality Improvement

Background:

  • The Veterans Affairs (VA) health system treats approximately 15,000 veterans annually across 40 radiation oncology facilities.
  • Ensuring high-quality care and consistent practice patterns is crucial for this patient population.
  • Existing quality assessment methodologies informed the development of a new surveillance program.

Purpose of the Study:

  • To develop and implement a quality surveillance program for radiation oncology services within the VA hospital system.
  • To assess the quality of care and identify practice variations among VA radiation oncology facilities.
  • To provide feedback to physicians for improving clinical outcomes and adopting evidence-based practices.

Main Methods:

  • The VA Radiation Oncology Quality Surveillance program was established, utilizing the methodology from the American College of Radiology Quality Research in Radiation Oncology project.
  • Clinical quality measures (QM) were developed by expert panels for prostate, non-small cell lung, and small cell lung cancers.
  • Data from 1567 patients across 40 VA facilities were abstracted from electronic medical records and treatment systems.

Main Results:

  • Across 1567 assessed cases, an overall pass rate of 82.4% was achieved for all quality measures.
  • Specific QM pass rates were 78.0% for 773 lung cancer cases and 87.2% for 794 prostate cancer cases.
  • Significant variations in QM pass rates were observed when analyzed by tumor site, clinical pathway, or treating facility.

Conclusions:

  • The VA Radiation Oncology Quality Surveillance program, utilizing peer-review protected quality measures, enables objective comparison of clinical practices.
  • This program facilitates unobtrusive identification of areas for improvement in individual practice patterns.
  • The initiative supports the enhancement of radiation therapy quality and patient care within the VA system.