Cancer'System'' Performance'Measurement' and'Repor5ng'' in'Canada ' - PowerPoint PPT Presentation

Cancer'System'' Performance'Measurement' and'Repor5ng'' in'Canada ' World&Cancer&Congress& 2012& 1

Presenters' • Heather'Bryant ,&MD,&PhD,&CCFP,&FRCPC& Vice&President,&Cancer&Programs,&Clinical&&& Popula?on&Health& Canadian&Partnership&Against&Cancer& • Rami'Rahal ,&BSc,&MBA& Director,&System&Performance&&&Surveillance& Canadian&Partnership&Against&Cancer& & 2

“Analysis&and&comparison&are& the&midwives&of&improvement.”& & Roy&Romanow,&Linda&Silas,&and&Steven&Lewis&& &from& The&Globe&and&Mail&(Jan&16,&2012) && 3

Hospital'Model' Adapted'from' Heenan'et'al,'2010' Big& dots & LiLle& Dots & Heenan, M, Kahn, H & Binkley, D (2010) “From Boardroom to Bedside: How to Define and Measure Hospital Quality” Healthcare Quarterly, 13(1): 55-60.

For'Na5onal'Cancer'Control' Na?onal& Outcome& Big& Indicators& dots & Na?onal/Province& Driver&Indicators& Medical/Clinical/Program&& Indicators&at&Province&Level& LiLle& Clinical&and&Corporate&Quality&and& Dots & Process&Indicators&

Poten5al'roles'for'na5onal'cancer'control' organiza5ons:'Analysis'and'repor5ng' Data&collec?on,&& analysis&and&& System& repor?ng&on& level& &“Big&Dots”& indicators& and&Key&Drivers& Program& level& indicator& Many&site& level& indicators&

Poten5al'roles'for'na5onal'cancer'control' organiza5ons' System& level& indicators& Development&of&& driver&indicators,& Program& &in&collabora?on&& level& with&prac?ce& indicator& Many&site& &leaders,&in&key& level& areas& indicators&

The'Collabora5ve'Model'for'System' Performance' • Priori?za?on& • Data&Collec?on&&& Analysis& • Repor?ng& • Quality&Improvement& 8

History'of'System'Performance' 2007& Cancer&Indicators&Conference&–&700&Indicators&to&50& 2008& Steering&CommiLee&established&–&feasibility&assessment&–&17&indicators& 2009& Inaugural&Report&(par?ally&anonymized&results)&/&Regional&Consulta?ons& 2010& 2 nd &Report&–&expansion&in&Treatment&indicators&/&Special&Insert&on&CRC&/&& Full&iden?fica?on&of&provinces& 9

History'of'System'Performance' 2011& 3 rd &Report,&35&Indicators&/&1 st &Special&Focus&Report:&Lung&Cancer& 2012& Regional&Consulta?ons&/&Special&Report&on&Breast&Cancer&/&2012&Report& 10

An'Example'System'Performance' Indicators'at'the'Na5onal'Level:' Breast'Cancer'Control' 11

An'Example'System'Performance' Indicators' • Upcoming&report:& Breast&Cancer&Control&in& Canada,&a&System&Performance&Special&Focus& Report& • 23&indicators&&(+&breakdowns)&addressing& preven?on,&screening,&diagnosis,&treatment,& pa?ent&experience,&enddof&life&care,&research,& and&long&term&outcomes.& • Release:&September&28 th ,&on&cancerview.ca& 12

SP'Indicator'Framework' ! Treatment)and)Care)) ! ! Prevention) Screening) Diagnosis) Surgery) Systemic)) Radiation) Pt.)Experience) Research) Long)Term) &)Recovery)) Outcomes) ! ! ! ! " Mastectomy/BCS! ! ! ! ! ! Safe) ! complication!/! ! infection!rates! ! ! " smoking! " Cervical!screening! " Capture!of!stage! " Removal/exam!>! " Adjuvant!chemo,! " Adjuvant!RXT! ! " Pediatric!and! " Incidence! cessation,! participation! data! 12!nodes!for! resected!Stage!II,!IIIA! after!breast! ! adult!clinical!trial! " Mortality!! Effective)) prevalence,! " Breast!screening! " Stage!distribution! colon!cancer! NSCLC! conserving! ! participation! " Relative!survival! second!hand! participation!! " ERPR,!HER2/neu! " Mastectomy/BCS! " Adjuvant!chemo,! surgery,!Stage!I,!II! ! " Conditional!survival exposure! " CRC!screening! rates! rates! resected!Stage!III! breast!ca! " HPV!vaccination! participation!! ! ! colon!ca! " Neo"adjuvant!RXT! rates! for!resected!Stage! ! II,!III!rectal!ca! ! " alcohol! ! ! ! ! ! " Patient!reported! ! ! Patient)or) " Fruits/vegetables! outcomes! population) " Physical!activity! " Place!of!death!! " Overweight!and! " Screening!for! centered) obesity! distress! ! " Satisfaction!with! continuity!of!care! ! ! " Wait!times:! " Cancer!surgery! ! " RXT!wait!times:! ! ! ! ! Abnormal!breast! wait!times!(with! Ready!to!treat!to! Timely/) ! screen!to! CIHI!–!by!cancer! treatment! Responsive) ! resolution!! type)! ! ! ! " HPV!vaccination! " SES!and!geographic!! " Pet!scanner! " Mastectomy/BCS! "!treatment!rates!by! " LINAC!capacity! ! ! " Incidence!by!SES! Equitable) rates! variations!in! capacity!! rates,!by! age!and!sex! and!distribution!! " Survival!by!SES! " SES!variations!in! screening!rates! geography!and! " Treatment!rates! (including! risk!factors! income! by!age!and!sex! accessibility ) ) ! ! ! ! " PET!scanner! " Length!of!stay! ! " LINAC!utilization!! ! " Research! ! Efficient) ! utilization!per! following! " RXT!utilization!! investment! machine! Mastectomy/BCS!! ! ! ! ! 21

Where'to'from'here' • Filling&in&the&framework&gaps&(efficiency,& pa?ent&experience,&etc.)& • Developing&performance&targets&and& benchmarks& • Knowledge&Transla?on&and&Exchange& strategies&to&bridge&gap&between&Knowledge& and&Ac?on& • Suppor?ng&system&improvement&inita?ves& 22