A Decade of QOPI in Spain: From Quality Measurement to Continuous Improvement in Oncology Practice

We evaluated 10 years of QOPI implementation in Spain to characterize quality performance across successive stages of participation, assess sustainability over time, compare performance with contemporaneous QOPI benchmarks, identify persistent certification gaps, and examine quality performance across repeated certification and reassessment cycles.

We conducted a longitudinal descriptive study of QOPI implementation in Spanish oncology practices between 2015 and 2025. Analyses included within-practice changes in QOPI quality measures among certified practices, comparing the last available pre-certification assessment with the first post-certification assessment, including disease-specific measures for breast, colorectal, and lung cancer; descriptive comparisons between first participation and post-certification assessments, benchmarking against the contemporaneous QOPI Aggregate, and findings from external certification and recertification surveys.

Within-practice longitudinal analyses among certified practices showed higher post-certification performance in several patient-centered measures, including emotional well-being assessment (75.56% to 85.20%), infertility risk discussion (70.33% to 78.67%), appropriate pain management (83.57% to 89.15%), and pain assessment (83.56% to 89.50%). Certified practices maintained broadly high performance over time, although lower post-certification performance was observed in some chemotherapy and other documentation measures. Benchmarking showed a shift: pain assessment, emotional well-being assessment, appropriate pain management, and infertility counseling moved from below to above the contemporaneous QOPI Aggregate after certification. External surveys identified recurrent opportunities for improvement in treatment verification and patient information and education.

A decade of QOPI implementation in Spain was associated with sustained high-quality performance, higher scores in selected patient-centered measures after certification, and the identification of persistent opportunities for improvement. Repeated measurement, benchmarking, certification, and reassessment may support organizational change and continuous quality improvement.