TY - JOUR
T1 - VA-Radiation Oncology Quality Surveillance Program
AU - Hagan, Michael
AU - Kapoor, Rishabh
AU - Michalski, Jeff
AU - Sandler, Howard
AU - Movsas, Benjamin
AU - Chetty, Indrin
AU - Lally, Brian
AU - Rengan, Ramesh
AU - Robinson, Cliff
AU - Rimner, Andreas
AU - Simone, Charles
AU - Timmerman, Robert
AU - Zelefsky, Michael
AU - DeMarco, John
AU - Hamstra, Daniel
AU - Lawton, Colleen
AU - Potters, Louis
AU - Valicenti, Richard
AU - Mutic, Sasa
AU - Bosch, Walter
AU - Abraham, Christopher
AU - Caruthers, Douglas
AU - Brame, Ryan
AU - Palta, Jatinder R.
AU - Sleeman, William
AU - Nalluri, Joseph
N1 - Funding Information:
Disclosures: R.K. is a VCU employee providing full time contracted services at VA. J.M. received a stipend from ASTRO for this project. H.S. received a stipend from ASTRO for this project; personal fees from Astra Zeneca, Novocure, IBA, and Janssen; and other from Radiogel, outside the submitted work. B.M. received a stipend from ASTRO for this project and other from ASTRO, during the conduct of the study; grants from Varian, Inc and Philips, Inc; and personal fees from View Ray Inc, outside the submitted work. I.C. received grants from Varian Medical Systems (Palo Alto, CA) and Philips HealthCare (Best, Netherlands), outside the submitted work. R.R. received personal fees from Astra Zeneca, Novocure, and IBA, outside the submitted work. C.R. received grants and personal fees from Varian, grants from Elekta, and other from Radialogica, outside the submitted work. A.R. received a stipend from ASRO for this project; institutional support from NIH/NCI Cancer Center Support Grant P30 CA008748; grants from Varian Medical Systems, Boehringer Ingelheim, and Pfizer; grants and personal fees from AstraZeneca and Merck; personal fees from Research to Practice, Cybrexa, and MoreHealth; and nonfinancial support from Philips/Elekta. D.H. received personal fees from ASTRO, during the conduct of the study; grants and personal fees from Augmenix; and personal fees from Boston Scientific, outside the submitted work. S.M.: received a stipend from ASTRO for this project; grants from the Veterans Health Administration; grants and other from Varian Medical Systems, Radialogica, and TreatSafely, during the conduct of the study; and grants and other from Varian Medical Systems outside the submitted work. W.B. received grants from the US Veterans Health Administration, during the conduct of the study, and other from American Association of Physicists in Medicine, outside the submitted work. D.C. received a stipend from ASTRO for this project. D.C. reports grants from the Veterans Health Administration, during the conduct of the study. R.B. reports being an employee of Radialogica, LLC, and receiving grants from the Veterans Health Administration, during the conduct of the study. J.R.P. reports being a VCU employee providing 0.7FTE contracted services at the VA. J.N. receives personal fees from Veteran Affairs Administration, during the conduct of the study. W.S. receives personal fees from Veteran Affairs Administration, during the conduct of the study.
Funding Information:
The funding for this project was provided by the Veterans Health Administration of the U.S. government.
Publisher Copyright:
© 2019
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Purpose: We sought to develop a quality surveillance program for approximately 15,000 US veterans treated at the 40 radiation oncology facilities at the Veterans Affairs (VA) hospitals each year. Methods and Materials: State-of-the-art technologies were used with the goal to improve clinical outcomes while providing the best possible care to veterans. To measure quality of care and service rendered to veterans, the Veterans Health Administration established the VA Radiation Oncology Quality Surveillance program. The program carries forward the American College of Radiology Quality Research in Radiation Oncology project methodology of assessing the wide variation in practice pattern and quality of care in radiation therapy by developing clinical quality measures (QM) used as quality indices. These QM data provide feedback to physicians by identifying areas for improvement in the process of care and identifying the adoption of evidence-based recommendations for radiation therapy. Results: Disease-site expert panels organized by the American Society for Radiation Oncology (ASTRO) defined quality measures and established scoring criteria for prostate cancer (intermediate and high risk), non-small cell lung cancer (IIIA/B stage), and small cell lung cancer (limited stage) case presentations. Data elements for 1567 patients from the 40 VA radiation oncology practices were abstracted from the electronic medical records and treatment management and planning systems. Overall, the 1567 assessed cases passed 82.4% of all QM. Pass rates for QM for the 773 lung and 794 prostate cases were 78.0% and 87.2%, respectively. Marked variations, however, were noted in the pass rates for QM when tumor site, clinical pathway, or performing centers were separately examined. Conclusions: The peer-review protected VA-Radiation Oncology Surveillance program based on clinical quality measures allows providers to compare their clinical practice to peers and to make meaningful adjustments in their personal patterns of care unobtrusively.
AB - Purpose: We sought to develop a quality surveillance program for approximately 15,000 US veterans treated at the 40 radiation oncology facilities at the Veterans Affairs (VA) hospitals each year. Methods and Materials: State-of-the-art technologies were used with the goal to improve clinical outcomes while providing the best possible care to veterans. To measure quality of care and service rendered to veterans, the Veterans Health Administration established the VA Radiation Oncology Quality Surveillance program. The program carries forward the American College of Radiology Quality Research in Radiation Oncology project methodology of assessing the wide variation in practice pattern and quality of care in radiation therapy by developing clinical quality measures (QM) used as quality indices. These QM data provide feedback to physicians by identifying areas for improvement in the process of care and identifying the adoption of evidence-based recommendations for radiation therapy. Results: Disease-site expert panels organized by the American Society for Radiation Oncology (ASTRO) defined quality measures and established scoring criteria for prostate cancer (intermediate and high risk), non-small cell lung cancer (IIIA/B stage), and small cell lung cancer (limited stage) case presentations. Data elements for 1567 patients from the 40 VA radiation oncology practices were abstracted from the electronic medical records and treatment management and planning systems. Overall, the 1567 assessed cases passed 82.4% of all QM. Pass rates for QM for the 773 lung and 794 prostate cases were 78.0% and 87.2%, respectively. Marked variations, however, were noted in the pass rates for QM when tumor site, clinical pathway, or performing centers were separately examined. Conclusions: The peer-review protected VA-Radiation Oncology Surveillance program based on clinical quality measures allows providers to compare their clinical practice to peers and to make meaningful adjustments in their personal patterns of care unobtrusively.
UR - http://www.scopus.com/inward/record.url?scp=85078096238&partnerID=8YFLogxK
U2 - 10.1016/j.ijrobp.2019.08.064
DO - 10.1016/j.ijrobp.2019.08.064
M3 - Article
C2 - 31983560
AN - SCOPUS:85078096238
SN - 0360-3016
VL - 106
SP - 639
EP - 647
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 3
ER -