Pediatric Oncology Group of Ontario (POGO), Toronto, ON, Canada.
Value Health. 2013 Jun;16(4):639-46. doi: 10.1016/j.jval.2013.02.016.
We described previously the development of a set of quality indicators (QIs) of a childhood cancer system in Ontario, Canada. The purpose of this study was to determine the acceptability of the proposed set of QIs among stakeholders of the childhood cancer system.
A modified Delphi method was used to assess stakeholder agreement on the value of the proposed QIs. A QI evaluation survey was mailed to a stakeholder group of 23 multidisciplinary health care providers, survivors, parents, and policymakers who rated each QI on specific criteria. Prior to an in-person consensus meeting, the distribution of scores was provided to panel members. At the meeting, QIs were reevaluated and discussed in three successive rounds. QIs with 80% or more of panel agreement were considered endorsed.
Overall, 20 QIs were endorsed by the panel, measuring all seven quality dimensions of Ontario's Cancer System Quality Index framework. Five QIs were endorsed by 100% of the panel as follows: Five-year event-free survival, chemotherapy admission delay, drug availability, sufficient multidisciplinary staff, and parent satisfaction. Although none of the QIs relating to end-of-life or Satellite care were endorsed, panel members emphasized the need to measure these components of the system.
Standardized implementation of the 20 pediatric cancer QIs endorsed by the multidisciplinary stakeholder panel will provide ongoing monitoring of various dimensions of system quality and the development of benchmarks over time, greatly augmenting the ability to identify needed system improvements across populations and jurisdictions.
我们之前描述了加拿大安大略省儿童癌症系统质量指标（QIs）的开发。本研究的目的是确定儿童癌症系统利益相关者对拟议的 QI 集的可接受性。
采用改良 Delphi 法评估利益相关者对拟议 QI 的价值的共识。向 23 名多学科医疗保健提供者、幸存者、父母和政策制定者的利益相关者小组邮寄了一份 QI 评估调查，他们根据特定标准对每个 QI 进行了评分。在进行面对面的共识会议之前，向小组成员提供了评分分布情况。在会议上，QI 在三个连续轮次中进行了重新评估和讨论。得到 80%或更多小组同意的 QI 被认为得到了认可。
总体而言，20 个 QI 得到了小组的认可，涵盖了安大略省癌症系统质量指数框架的所有七个质量维度。五项 QI 得到了小组 100%的认可，包括：五年无事件生存率、化疗入院延迟、药物可获得性、足够的多学科工作人员和家长满意度。虽然没有一项与临终关怀或卫星护理相关的 QI 得到认可，但小组成员强调需要衡量系统的这些组成部分。
多学科利益相关者小组认可的 20 项儿科癌症 QI 的标准化实施将提供对系统质量各个维度的持续监测，并随着时间的推移制定基准，极大地提高了在不同人群和司法管辖区识别系统改进需求的能力。
