Staff perceptions of change resulting from participation in a European cancer accreditation programme:a snapshot from eight cancer centres

Background: Healthcare accreditation is considered to be an essential quality improvement tool. However, its effectiveness has been critiqued. Methods: Twenty-four interviews were conducted with clinicians (five), nurses (six), managers (eight), and basic/translational researchers (five) from eight European cancer centres on changes observed from participating in a European cancer accreditation programme. Data were thematically analysed and verified with participants and checked against auditor’s feedback. Results: Four change categories emerged: (i) the growing importance of the nursing and supportive care field (role change). Nurses gained more autonomy/clarity on their daily duties. Importance was given to the hiring and training of supportive care personnel (ii) critical thinking on data integration (strategic change). Managers gained insight on how to integrate institutional level data (iii) improved processes within multidisciplinary team (MDT) meetings (procedural change). Clinical staff experienced improved communication between MDTs (iv) building trust (organisational change). Accreditation improved the centre’s credibility with its own staff and externally with funders and patients. No motivational changes were perceived. Researchers perceived no changes. The auditor’s feedback included changes in 13 areas: translational research, biobanks, clinical trials, patient privacy and satisfaction, cancer registries, clinical practice guidelines, patient education, screening, primary prevention, role of nurses, MDT, supportive care, and data integration. However, our study revealed that staff perceived changes only in the last four areas. Conclusion: Staff perceived changes in data integration, nursing and supportive care, and in certain clinical aspects. Accreditation programmes must pay attention to the needs of different stakeholder groups, track changes, and observe how/why change happens

Management and performance features of cancer centers in Europe : A fuzzy-set analysis

The specific aim of this study is to identify the performance features of cancer centers in the European Union by using a fuzzy-set qualitative comparative analysis (fsQCA). The fsQCA method represents cases (cancer centers) as a combination of explanatory and outcome conditions. This study uses data on seven centers from a European benchmarking project: BENCH-CAN. The fsQCA uses the net income and productivity as the outcome conditions and five explanatory conditions: the level of dedication to R&D, annual budget level, size, type, and whether the center is a comprehensive cancer center. Despite the modest number of cases, the study successfully applies the fsQCA. The findings show that public, comprehensive cancer centers with at least two of the three other explanatory conditions (dedication to R&D, annual budget, or size) have an association with high net income and high productivityinfo:eu-repo/semantics/publishedVersio

第792回 千葉医学会例会・第二内科例会 47.

Problems per ECCQI-question. This file gives an overview of the problems identified per question during the cognitive interviews and through feedback on the questionnaire. (DOCX 20 kb

Analysing the attributes of Comprehensive Cancer Centres and Cancer Centres across Europe to identify key hallmarks.

There is a persistent variation in cancer outcomes among and within European countries suggesting (among other causes) inequalities in access to or delivery of high-quality cancer care. European policy (EU Cancer Mission and Europe's Beating Cancer Plan) is currently moving towards a mission-oriented approach addressing these inequalities. In this study, we used the quantitative and qualitative data of the Organisation of European Cancer Institutes' Accreditation and Designation Programme, relating to 40 large European cancer centres, to describe their current compliance with quality standards, to identify the hallmarks common to all centres and to show the distinctive features of Comprehensive Cancer Centres. All Comprehensive Cancer Centres and Cancer Centres accredited by the Organisation of European Cancer Institutes show good compliance with quality standards related to care, multidisciplinarity and patient centredness. However, Comprehensive Cancer Centres on average showed significantly better scores on indicators related to the volume, quality and integration of translational research, such as high-impact publications, clinical trial activity (especially in phase I and phase IIa trials) and filing more patents as early indicators of innovation. However, irrespective of their size, centres show significant variability regarding effective governance when functioning as entities within larger hospitals

Benchmarking comprehensive cancer care

The number of cancer patients and survivors is steadily increasing and despite or perhaps because of rapid improvements in diagnostics and therapeutics, important inequalities in cancer survival exist within and between different countries in Europe. Improving the quality of care is part of the approach to reduce suboptimal cancer survival and minimize inequalities in Europe. The aim of this thesis was to contribute to the knowledge on how to develop and use benchmarking for quality improvement of cancer care, the BENCH-CAN project. To inform the development of this tool a scoping literature review was performed on benchmarking specialty hospitals. Secondly a survey was performed to get an overview of existing quality assessments and which indicators they use. o account for the patients perspective in quality of care we developed and tested the European Cancer Consumer Quality Index. Chapter 5 and 6 discuss the main research objectives of this study; the development and use of two benchmark tools. Chapter 5 describes the development and pilot of a benchmark tool for the whole institute. The second tool benchmarked cancer care pathways and was used to assess the degree towards Integrated Practice Units in cancer centers in Europe. For chapter 7 we applied a relatively new method (fuzzy-set qualitative comparative analysis (fsQCA)) within health service research to identify performance features of cancer centers in the European Union using the data collected through the benchmark tools. This method represents cases (cancer centers) as a combination of explanatory and outcome conditions and is a method to identify the importance of quantitative performance features and how they relate to outcomes. An overview of actual prices of cancer drugs in European countries does, to our knowledge, not exist, and anecdotal evidence suggested that differences in price levels might be high. Therefore we benchmarked the prices for several cancer drugs in European countries. We noted substantial price differences in the prices of cancer drugs in this illustrative example from 15 European countries

Parenting stress in mothers and fathers of a child with a hemiparesis: sources of stress, intervening factors and long-term expressions of stress

Background: In a substantial minority of children with a hemiparesis, motor impairments are accompanied by behavioural problems. This combination confronts parents with several persistent, frequently intense, sources of stress. At the same time, it is likely to reduce the effectiveness of psychosocial resources, such as feelings of competence, which would normally buffer the impact of the stressors. Aim: To investigate the association between motor and behavioural problems in children with a hemiparesis and symptoms of stress in their parents, with particular attention to psychosocial factors which may mediate between the child's problems and parents'symptoms of stress. Method: Questionnaires assessing the medical, functional and behaviour problems of the child, and the parents'experience of stress were completed by the mothers and fathers of 108 children with a hemiparesis who were members of the Association for the Motor Handicapped in the Netherlands. Results: Both parents reported (extremely) high levels of long-term stress significantly more frequently than parents in a normative sample. Indices of long-term stress were associated with the child's behavioural problems and, less strongly, with dysfunctionality in daily life. However, behavioural problems and dysfunctionality also reduced parents'feelings of competence and social support. A mediation analysis showed that feelings of incompetence and social isolation mediated between the child's problems and the parents' symptoms of stress. Fathers and mothers did not differ in level of reported stress, or in the associations between the child's problems and degree of experienced stress. Conclusion: Both parents of a child with a hemiparesis experience high levels of stress, which are strongly associated with feelings of incompetence and social isolation. This suggests that one focus of intervention should be the alleviation of parenting stress with particular attention to increasing perceived competence in the parenting role and reducing feelings of social isolation

Assessing and comparing the quality of wound centres: a literature review and benchmarking pilot

Multidisciplinary wound centres are currently facing an increase in both the incidence of wounds and the complexity of care. This has resulted in rising costs and increased interest in the effectiveness of treatments. Little evidence is available regarding optimal wound centre organisation and effectiveness; therefore, measuring the quality of wound centres has become more important. This study aims to assess the evidence concerning quality by describing the state of the art of wound centres and organisational effectiveness by developing indicators of quality and by assessing their suitability in a pilot study. A multi-method approach was used: a literature review performed resulted in the development of an indicator list that was consequently subjected to expert review, and a benchmark study was completed comparing eight wound centres in the Netherlands. We thus provide a description of the relevant state-of-the-art aspects of wound centre organisation, which were multidisciplinary collaborations and standardisation of the organisation of care. In literature, significant patient-related effects were observed in improved healing rates and decreased costs. A total of 48 indicators were selected. The indicator list was tested by a benchmark study pilot. In practice, the outcome indicators were especially difficult to generate. Six indicators regarding structure, three regarding process and five regarding outcome proved feasible to measure and improve quality of wound centres

Additional file 1: of Quality assessments for cancer centers in the European Union

Questionnaire Quality assessments Cancer Centers. This file contains the survey that was send to the cancer centers to obtain the data. (DOC 40 kb

Additional file 2: Table 2. of Quality assessments for cancer centers in the European Union

Scope and nature of assessments. This table contains information regarding the Scope (patient, research, combination) and Nature (mandatory or voluntary) of the assessments per country. (DOC 49 kb

Additional file 3: Table 3. of Quality assessments for cancer centers in the European Union

Overview of assessments including details per country. This table contains all assessments included in this study, divided per country and category (patient, research, combination). (DOC 124 kb