Certification of breast centres in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer care

<p>Abstract</p> <p>Background</p> <p>The main study objectives were: to develop a set of requirements of comprehensive breast centres; to establish a nationwide voluntary certification programme for breast centres based on such requirements, a certified quality management system (QMS), and scheduled independent, external audits and periodic recertification; and to demonstrate the general acceptance of such a certification programme with a view to introducing similar certification programmes for other major cancers.</p> <p>Methods</p> <p>Breast centres introduced a QMS and voluntarily participated in an external certification procedure based on guideline-derived Requirements of Breast Centres specifically developed for the application procedure, all subsequent audits and recertification. All data (numbers of pending and successful applications, sites/centre, etc.) were collected by a newly founded, independent organisation for certification of cancer services delivery. Data analysis was descriptive.</p> <p>Results</p> <p>Requirements of Breast Centres were developed by the German Cancer Society (DKG), the German Society of Senology (DGS) and other relevant specialist medical societies in the form of a questionnaire comprising 185 essential items based on evidence-based guidelines and the European Society of Breast Cancer Specialists' (EUSOMA) requirements of specialist breast units. From late 2002 to mid 2008, the number of participating breast centres rose from 1 to 175. As of mid 2008, 77% of an estimated 50,000 new breast cancers in Germany were diagnosed and treated at certified breast centres, 78% of which were single-site centres.</p> <p>Conclusion</p> <p>Nationwide voluntary certification of breast centres is feasible and well accepted in Germany. Dual certification of breast centres that involves certification of breast services to guideline-derived requirements in conjunction with independent certification of a mandatory QMS can serve as a model for other multidisciplinary site-specific cancer centres.</p

Die OncoBox Research als Instrument für Versorgungsforschung

Background. One of the objectives of certification of organ cancer centers is the continuous improvement of the quality of care. This is achieved through the fulfillment and further development of the certification requirements, comparison of own performance data with those of the other centers and mutual learning. To date, performance data have been documented as an aggregate at the center level. Aim. Currently, the OncoBox Research is being developed to enable analyses that take into account the different distribution of patient characteristics (case mix) between the centers. This article provides a brief overview of the current state of health services research and documentation in certified centers, shows examples of the limitations of previous evaluations and outlines the potentials of OncoBox Research. Material and methods. The OncoBox Research is a further development of the OncoBox, which is already used by breast, colorectal and prostate cancer centers in order to make the data between the centers comparable and to allow the centers quality assurance during data collection. The OncoBox Research is intended to allow the use of these data for research purposes. Key fields of application are case mix adjusted center comparisons and the investigation of specific research questions. For example, such specific questions on key figures can consider how strong guideline adherence between patient groups and centers varies and based on which features. Results and discussion. The OncoBox Research is currently under development. The potential consists of the combination of a technical data analysis with a social, research cooperative innovation. Its success is essentially dependent on the interest of the contributing centers