Abstract
Improving the quality of health care has become a national priority, as indicated by the establishment of multiple federal initiatives and by the actions of national medical societies and the American Board of Medical Specialties. Health care can be assessed in each of three dimensions: structure, process, and outcomes. Here we review recent efforts to evaluate the quality of care delivered to head and neck cancer patients and to develop methods for improvement and continual assessment, with a particular emphasis on the evaluation of process of care.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Institute of Medicine: Crossing the Quality Chasm: A New Health System for the Twenty-first Century. Washington, DC: National Academy Press; 2001.
Berwick DM: A user's manual for the IOM's 'Quality Chasm' report. Health Aff (Millwood) 2002, 21(3):80-90.
Weber RS: Improving the quality of head and neck cancer care. Arch Otolaryngol Head Neck Surg 2007, 133(12):1188-1192.
Agency for Healthcare Research: Your Guide to Choosing Quality Health Care: A Quick Look at Quality. Available at http://www.ahrq.gov/consumer/qnt/qntqlook.htm. Accessed October 2010.
Donabedian A: Quality of care: problems of measurement. II. Some issues in evaluating the quality of nursing care. Am J Public Health Nations Health 1969, 59(10):1833-1836.
Sox HC: Comparative effectiveness research: a progress report. Ann Intern Med 2010, 153(7):469-472.
Institute of Medicine: Initial Priorities for Comparitive Effectiveness Research. Washington, DC: National Academic Press; 2009.
Clancy C, Collins FS: Patient-centered outcomes research institute: the intersection of science and health care. Sci Transl Med 2010, 2(37):37 cm18.
••National Quality Forum: NQF-Endorsed Standards. Available at http://www.qualityforum.org/Measures_List.aspx. Accessed October 2010. The NQF develops and endorses both general and disease-specific performance indicators.
Chen AY: The development of quality care measures for oral cavity cancer. Arch Otolaryngol Head Neck Surg 2008, 134:672.
••American Head and Neck Society: AHNS Quality of Care Article. Available at http://www.ahns.info/documents/AAO_AHNS_2009_Chen.pdf. Accessed October 2010. This document summarizes the AHNS quality indicators for oropharyngeal and laryngeal cancer care.
Chen AY, Pavluck A, Halpern M, Ward E: Impact of treating facilities' volume on survival for early-stage laryngeal cancer. Head Neck 2009, 31(9):1137-1143.
Chen AY, Fedewa S, Pavluck A, Ward EM: Improved survival is associated with treatment at high-volume teaching facilities for patients with advanced stage laryngeal cancer. Cancer 2010, 116(20):4744-4752.
Kelly M, Morgan A, Ellis S, Younger T, Huntley J, Swann C: Evidence based public health: A review of the experience of the National Institute of Health and Clinical Excellence (NICE) of developing public health guidance in England. Soc Sci Med, 71(6):1056-1062.
Jeannon JP, Abbs I, Calman F, Gleeson M, Lyons A, Hussain K, McGurk M, O'Connell M, Probert D, Ng R et al: Implementing the National Institute of Clinical Excellence improving outcome guidelines for head and neck cancer: developing a business plan with reorganisation of head and neck cancer services. Clin Otolaryngol 2008, 33(2):149-151.
Chen AY, Schrag NM, Halpern MT, Ward EM: The impact of health insurance status on stage at diagnosis of oropharyngeal cancer. Cancer 2007, 110(2):395-402.
Chen AY, Schrag NM, Halpern M, Stewart A, Ward EM: Health insurance and stage at diagnosis of laryngeal cancer: does insurance type predict stage at diagnosis? Arch Otolaryngol Head Neck Surg 2007, 133(8):784-790.
••Goodwin WJ, Thomas GR, Parker DF, Joseph D, Levis S, Franzmann E, Anello C, Hu JJ: Unequal burden of head and neck cancer in the United States. Head Neck 2008, 30(3):358-371. This is a well-organized and thorough discussion exploring the potential etiologies of head and neck cancer disparities.
Molina MA, Cheung MC, Perez EA, Byrne MM, Franceschi D, Moffat FL, Livingstone AS, Goodwin WJ, Gutierrez JC, Koniaris LG: African American and poor patients have a dramatically worse prognosis for head and neck cancer: an examination of 20,915 patients. Cancer 2008, 113(10):2797-2806.
Beitler JJ, Chen AY, Jacobson K, Owens A, Edwards M, Johnstone PA: Health literacy and health care in an inner-city, total laryngectomy population. Am J Otolaryngol, 31(1):29-31.
Fillion L, de Serres M, Cook S, Goupil RL, Bairati I, Doll R: Professional patient navigation in head and neck cancer. Semin Oncol Nurs 2009, 25(3):212-221.
••National Comprehensive Cancer Network: NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. Available at http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed October 2010. These clinical practice guidelines for head and neck cancer management are based on the best available evidence.
••Hessel AC, Moreno MA, Hanna EY, Roberts DB, Lewin JS, El-Naggar AK, Rosenthal DI, Weber RS: Compliance with quality assurance measures in patients treated for early oral tongue cancer. Cancer 2010, 116(14):3408-3416. This study used clinical guidelines to create quality indicators and clinical end points in the care of oral cavity cancer and evaluated compliance within an academic department.
••Lewis CM, Hessel AC, Roberts DB, Guo YZ, Holsinger FC, Ginsberg LE, El-Naggar AK, Weber RS: Head and Neck Cancer Patients Referred to a Tertiary Center After Prior Treatment: Compliance with or Deviation from National Comprehensive Cancer Network Treatment Guidelines Arch Otolaryngol Head Neck Surg 2010, 136(12):1205‐1211. Head and neck cancer care delivered prior to referral to a tertiary care center was examined for NCCN guideline compliance.
••Peters LJ, O'Sullivan B, Giralt J, Fitzgerald TJ, Trotti A, Bernier J, Bourhis J, Yuen K, Fisher R, Rischin D: Critical impact of radiotherapy protocol compliance and quality in the treatment of advanced head and neck cancer: results from TROG 02.02. J Clin Oncol 2010, 28(18):2996-3001. Not only did this study evaluate deviation from established protocol, it then determined the impact of such noncompliance on patient outcomes.
Chen AY, Callender D, Mansyur C, Reyna KM, Limitone E, Goepfert H: The impact of clinical pathways on the practice of head and neck oncologic surgery: the University of Texas M. D. Anderson Cancer Center Experience. Arch Otolaryngol Head Neck Surg 2000, 126(3):322-326.
Gendron KM, Lai SY, Weinstein GS, Chalian AA, Husbands JM, Wolf PF, DiDonato L, Weber RS: Clinical care pathway for head and neck cancer: a valuable tool for decreasing resource utilization. Arch Otolaryngol Head Neck Surg 2002, 128(3):258-262.
Khuri SF, Daley J, Henderson WG: The comparative assessment and improvement of quality of surgical care in the Department of Veterans Affairs. Arch Surg 2002, 137(1):20-27.
•Stachler RJ, Yaremchuk K, Ritz J: Preliminary NSQIP results: a tool for quality improvement. Otolaryngol Head Neck Surg 2010, 143(1):26-30, 30 e21-23. The need for continuous quality assessment and transparency of results is emphasized.
••Weber RS, Lewis CM, Eastman SD, Hanna EY, Akiwumi O, Hessel AC, Lai SY, Kian L, Kupferman ME, Roberts DB: Quality and Performance Indicators in an Academic Department of Head and Neck Surgery. Arch Otolaryngol Head Neck Surg 2010, 136(12):1212‐1218. Performance indicators specific to head and neck surgery were established and used to evaluate surgeons on an individual basis.
Chen AY: Quality initiatives in head and neck cancer. Curr Oncol Rep 2010, 12(2):109-114.
Sherman AC, Simonton S: Advances in quality of life research among head and neck cancer patients. Curr Oncol Rep 2010, 12(3):208-215.
Disclosure
No potential conflicts of interest relevant to this article were reported.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lewis, C.M., Weber, R.S. & Hanna, E.Y. Quality of Care in Head and Neck Cancer. Curr Oncol Rep 13, 120–125 (2011). https://doi.org/10.1007/s11912-010-0146-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11912-010-0146-8