Dy Sydney M
J Support Oncol. 2013 Dec;11(4):160-4. doi: 10.12788/j.suponc.0017.
Oncology quality measurement programs should include measures in key domains of palliative care and supportive oncology. This article describes an approach to quality measurement in these areas including the key steps of defining the quality measurement goal; identifying stakeholders and audiences; defining the population and setting (including potential characteristics of interest, such as specific conditions or disparities); and choosing the domain, target, and steps in the process of care, such as assessment and treatment. Other key steps include choosing or adapting measures that have been evaluated in other settings or are in widespread use; identifying data sources or collection needs; and considering issues of scientific acceptability, such as evidence to support process-outcome relationships. Other quality measurement considerations include the challenges of measurement, particularly in important domains such as communication and spiritual care, variation in patient preferences, or inconsistent documentation. In addition, potential unintended consequences, such as measurement burden and overemphasis of checklist care, may reduce patient-centeredness and attention to important patient concerns not addressed by quality measures.
肿瘤学质量衡量项目应纳入姑息治疗和支持性肿瘤学关键领域的衡量指标。本文描述了这些领域质量衡量的一种方法，包括定义质量衡量目标的关键步骤；识别利益相关者和受众；定义人群和环境（包括感兴趣的潜在特征，如特定病症或差异）；以及在护理过程中选择领域、目标和步骤，如评估和治疗。其他关键步骤包括选择或调整已在其他环境中评估过或广泛使用的衡量指标；识别数据来源或收集需求；以及考虑科学可接受性问题，如支持过程与结果关系的证据。其他质量衡量考量包括衡量的挑战，尤其是在沟通和精神护理等重要领域、患者偏好的差异或记录不一致的情况。此外，潜在的意外后果，如衡量负担和对清单式护理的过度强调，可能会降低以患者为中心的程度，并减少对质量衡量未涉及的重要患者问题的关注。
