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Improved guideline compliance after a 3‐year audit of multidisciplinary colorectal cancer care in the western part of the Netherlands
Author(s) -
van der Geest Lydia G.M.,
Krijnen Pieta,
Wouters Michel W.J.M.,
Erkelens Willemien G.W.,
Marinelli Andreas W.K.S.,
Nortier Hans J.W.R.,
Tollenaar Rob A.E.M.,
Struikmans Henk
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23038
Subject(s) - medicine , colorectal cancer , guideline , audit , stage (stratigraphy) , cancer , total mesorectal excision , general surgery , pathology , paleontology , management , economics , biology
Background From 2006 to 2008, an audit of the multidisciplinary diagnosis and treatment of colorectal cancer patients in the western part of the Netherlands was carried out. We evaluated whether compliance with guidelines had improved. Methods All patients with newly diagnosed and surgically treated colon (n = 1,667) and rectal cancer (n = 544) stage I–III were evaluated. Nine quality indicators were derived from the evidence‐based guidelines. In order to compare hospital performances, hospital results were adjusted for casemix differences between hospitals. Results Colon cancer patients showed an increase in the examination of 10 or more lymph nodes (from 53% to 78%, P < 0.0001). For rectal cancer patients there was an increase in preoperative visualisation of the total colon (63–74%, P = 0.02), MRI (73–85%, P = 0.003), radiotherapy (from 82% to 93% for patients <75 years, P = 0.01) and examination of at least 10 lymph nodes (40–55%, P = 0.004). In 2006, standardised hospital performances differed widely for all quality indicators. Two years later, hospital performances for some quality indicators were more similar. Conclusions After the feedback of benchmark information, compliance with guidelines for diagnosis and treatment of colorectal cancer patients improved, and differences between individual hospitals decreased. Although secular trends cannot be ruled out, it is highly likely that these results can be attributed to the audit. J. Surg. Oncol. 2012; 106:1–9. © 2012 Wiley Periodicals, Inc.