Radtke Jan Philipp, Albers Peter, Hadaschik Boris A, Graefen Markus, Meyer Christian P, Behr Björn, Nüesch Stephan
Department of Urology, Medical Faculty, Heinrich-Heine-University Düsseldorf, 40225 Düsseldorf, Germany.
Department of Radiology, German Cancer Research Center (dkfz), 69120 Heidelberg, Germany.
Healthcare (Basel). 2024 May 11;12(10):991. doi: 10.3390/healthcare12100991.
Prostate cancer (PC) is the most common cancer in men in 112 countries, and accounts for 15% of cancers. Because it cannot be prevented, the rise in cases is inevitable, and improvements in diagnostic pathways and treatments are needed, as there is still a shortage of cost-effective diagnostics and widespread oncologically safe treatment options with measurable quality. As part of the implementation of a Full Cycle of Care, instruments have been developed to achieve value-based medicine, such as consistent commitment to measurability. One of these instruments is the Balanced Scorecard (BSC). Here, we propose the first BSC for prostate cancer (PC) treatment.
BSCs are used to assess performance in healthcare organizations across four dimensions: financial, patient and referrer, process, and learning and development. This study aimed to identify Key Performance Indicators (KPIs) for each perspective. A systematic literature search was conducted according to PRISMA guidelines using multiple databases and specific search terms to identify KPIs for PC care, excluding case reports and conference abstracts. In total, 44 reports were included in analyses and development of the PC-specific BSC.
In the present study, a PC-specific BSC and KPIs were defined for the four classic perspectives, as well as for a newly developed PC-Specific Disease and Outcome perspective, including patient-related parameters from the German Cancer Society and the International Consortium for Health Outcomes Measurement. In addition, the Process perspective includes KPIs of fulfillment of continuing education of residents and the metrics of structured training of the radical prostatectomy procedure in the Learning and Development perspective.
The developed BSC provides a comprehensive set of perspectives for an Integrated Practice Unit or center in PC care, ensuring that the indicators remain manageable and applicable. The BSC facilitates value creation in line with Porter's Full Cycle of Care by systematically collecting and providing economic, personnel, and medical results, actions, and indicators. In particular, this BSC includes KPIs of structured training of practitioners and metrics of the German Cancer Society, that recently proved to improve PC patients outcomes.
前列腺癌（PC）是112个国家男性中最常见的癌症，占癌症总数的15%。由于无法预防，病例数的增加不可避免，因此需要改进诊断途径和治疗方法，因为目前仍缺乏具有成本效益的诊断方法以及广泛的、具有可衡量质量且肿瘤学上安全的治疗选择。作为实施全周期护理的一部分，已开发出实现基于价值医疗的工具，例如对可衡量性的持续承诺。其中一种工具是平衡计分卡（BSC）。在此，我们提出首个用于前列腺癌（PC）治疗的平衡计分卡。
平衡计分卡用于从四个维度评估医疗保健组织的绩效：财务、患者及转诊者、流程以及学习与发展。本研究旨在确定每个维度的关键绩效指标（KPI）。根据PRISMA指南，使用多个数据库和特定搜索词进行系统的文献检索，以确定前列腺癌护理的关键绩效指标，排除病例报告和会议摘要。总共44份报告被纳入前列腺癌特定平衡计分卡的分析和制定。
在本研究中，针对四个经典维度以及新开发的前列腺癌特定疾病与结果维度定义了前列腺癌特定平衡计分卡和关键绩效指标，后者包括来自德国癌症协会和国际健康结果测量联盟的患者相关参数。此外，流程维度包括住院医师继续教育完成情况的关键绩效指标，学习与发展维度包括根治性前列腺切除术结构化培训的指标。
所开发的平衡计分卡为前列腺癌护理中的综合实践单位或中心提供了一套全面的维度，确保指标易于管理且适用。平衡计分卡通过系统地收集和提供经济、人员及医疗结果、行动和指标，促进符合波特全周期护理的价值创造。特别是，该平衡计分卡包括从业者结构化培训的关键绩效指标和德国癌症协会的指标，最近已证明这些指标可改善前列腺癌患者的治疗结果。
