Implementation of a Hospital-Based Quality Assessment Program for Rectal Cancer

Hendren, Samantha; McKeown, Ellen; Morris, Arden M.; Wong, Sandra L.; Oerline, Mary; Poe, Lyndia; Campbell, Darrell A.; Birkmeyer, Nancy J. O.

doi:10.1200/jop.2014.001387

Cited by 8 publications

(6 citation statements)

References 24 publications

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“…This study evaluated CRC resection patients at 42 MSQC hospitals that elected to participate in the MSQC's CRC Project from 2016 to 2020 [ 1 , 21 , 22 ]. In addition to routine clinical data, cancer-specific data on colorectal cancer operations was used in our analysis.…”

Section: Methodsmentioning

confidence: 99%

Positive margin rates for colorectal cancer vary significantly by hospital in Michigan: Can we achieve a 0 % positive margin rate?

Bertoy,

Harbaugh,

Millis

et al. 2023

Surgery Open Science

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Section: Methodsmentioning

confidence: 99%

Positive margin rates for colorectal cancer vary significantly by hospital in Michigan: Can we achieve a 0 % positive margin rate?

Bertoy,

Harbaugh,

Millis

et al. 2023

Surgery Open Science

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“…7 In 2014, the Michigan Surgical Quality Collaborative (MSQC) started a "colorectal cancer (CRC) project" in which trained nurses in Michigan hospitals abstracted cancer-specific quality measures for CRC surgical cases. 12 This effort provided a unique database of RC cases, for which tumor location, the performance of staging tests, and detailed patient data are available. We previously reported underuse of neoadjuvant therapy for patients with clinical stage II/III RC from this database, a problem that persists in data up to the present day.…”

Section: Pacientesmentioning

confidence: 99%

Lack of Complete Pretreatment Staging Is Associated With Omission of Neoadjuvant Therapy for Rectal Cancer: A Statewide Study

Tang

Rivard

Weng

et al. 2022

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Standardized local staging and neoadjuvant therapy are rectal cancer management quality measures supported by the Commission on Cancer and National Accreditation Program for Rectal Cancer for the management of rectal cancer. Previous studies suggested that up to 25% of patients with stage II/III rectal cancer patients do not receive neoadjuvant therapy. We hypothesized that failure to receive neoadjuvant therapy may be caused by failure to properly stage patients before surgery. OBJECTIVE: This study aimed to determine whether lack of local rectal cancer staging is associated with underutilization of neoadjuvant therapy and to determine risk factors for omission of neoadjuvant therapy. DESIGN: Retrospective cohort study. Bivariate and multivariable analyses were performed on patient, tumor, and 30-day outcome factors associated with neoadjuvant therapy and staging. SETTINGS: hospitals participated in the Michigan Surgical Quality Collaborative Colorectal Cancer Project from January 2014 to December 2019. PATIENTS: Elective, clinical stage II/III, mid-to-low rectal cancer resections. Patients with upper rectal cancer were excluded. MAIN OUTCOME MEASURES: Percentage of patients receiving neoadjuvant therapy. RESULTS: The final cohort included 350 patients with clinical stage II/III mid or low rectal cancer—80.9% of patients who had received neoadjuvant therapy and 83.2% of patients who had MRI and/or endoscopic ultrasound. A significant association was found between receiving neoadjuvant therapy and MRI/endorectal ultrasound staging (p < 0.0001). Eighty-seven percent of patients who had MRI/endorectal ultrasound received neoadjuvant chemoradiotherapy; 49% of patients who did not have MRI/endorectal ultrasound staging received neoadjuvant chemoradiotherapy. Multivariate analysis revealed that risk factors for the omission of neoadjuvant therapy were older age and incomplete staging. LIMITATIONS: Observational study with the possibility of unmeasured confounding variables. CONCLUSIONS: Neoadjuvant therapy is underused in patients with stage II/III rectal cancer. Omission of pretreatment staging with MRI/endorectal ultrasound is associated with omission of neoadjuvant therapy. These data suggest the need for regional and national quality improvement strategies to standardize the multidisciplinary management of rectal cancer. See Video Abstract at http://links.lww.com/DCR/B923. LA FALTA DE ESTADIFICACIÓN COMPLETA PREVIA AL TRATAMIENTO SE ASOCIA CON LA OMISIÓN DE LA TERAPIA NEOADYUVANTE PARA EL CÁNCER DE RECTO: UN ESTUDIO ESTATAL ANTECEDENTES: La estadificación local estandarizada y la terapia neoadyuvante son medidas de calidad de la Comisión sobre el Cáncer y el Programa Nacional de Acreditación para el Cáncer de Recto para el tratamiento del cáncer de recto. Estudios previos sugirieron que hasta el 25% de los pacientes con cáncer de recto en estadio II/III no reciben terapia neoadyuvante. Planteamos la hipótesis de que la falla en recibir la terapia neoadyuvante puede deberse a la falla...

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“…Recently, a special project measuring the quality of care for rectal cancer has been added to the colorectal surgery component of MSQC. 13 Piloted in 24 volunteer hospitals, this program adds to the MSQC core metrics a set of key process and outcome quality measures essential to the evaluation of the quality of colorectal cancer surgery. Information related to lymph node procurement, margin positivity, mesorectal excision grading, the use of neoadjuvant chemoradiotherapy, ostomy nurse care, and cancer recurrence are some examples of the detailed data that will be collected through this program.…”

Section: Msqc Research In Colorectal Surgery Colorectal Surgery Initimentioning

confidence: 99%

Statewide Clinic Registries: The Michigan Surgical Quality Collaborative

Nikolian

Regenbogen

2019

Clinics in Colon and Rectal Surgery

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Regional clinical registries provide a unique opportunity for shared learning and population-based analyses of the quality of surgical care. Through the “Michigan Model” of pay for participation in strategic Value Partnerships, exemplified by the Michigan Surgical Quality Collaborative (MSQC), the state's dominant private insurer, Blue Cross Blue Shield of Michigan, has sponsored 20 statewide clinical quality improvement collaboratives. MSQC represents a partnership among 73 Michigan hospitals with a robust data infrastructure and flexible platform for the promulgation of best practices in surgical quality improvement. This article will describe the organizational structure of the MSQC, the contributions the registry has made to quality improvement in colorectal surgery, and how future work will align to improve the reliability of improvement-relevant registry data.

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Implementation of a Hospital-Based Quality Assessment Program for Rectal Cancer

Cited by 8 publications

References 24 publications

Positive margin rates for colorectal cancer vary significantly by hospital in Michigan: Can we achieve a 0 % positive margin rate?

Positive margin rates for colorectal cancer vary significantly by hospital in Michigan: Can we achieve a 0 % positive margin rate?

Lack of Complete Pretreatment Staging Is Associated With Omission of Neoadjuvant Therapy for Rectal Cancer: A Statewide Study

Statewide Clinic Registries: The Michigan Surgical Quality Collaborative

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