Cancer Nursing

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Cancer Nursing:
doi: 10.1097/NCC.0b013e318210e3a2

Development of Generic Quality Indicators for Patient-Centered Cancer Care by Using a RAND Modified Delphi Method

Uphoff, Eleonora P. M. M. BSc; Wennekes, Lianne MSc; Punt, Cornelis J. A. MD, PhD; Grol, Richard P. T. M. PhD; Wollersheim, Hub C. H. MD, PhD; Hermens, Rosella P. M. G. PhD; Ottevanger, Petronella B. MD, PhD

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Background: Despite growing attention to patient-centered care, the needs of cancer patients are not always met.

Objective: Using a RAND modified Delphi method, this study aimed to systematically develop evidence-based indicators, to be used to measure the quality of patient-centered cancer care as a first step toward improvement.

Methods: First, key recommendations were identified from literature and were distributed over 5 domains of patient-centered cancer care: communication, physical support, psychosocial care, after-care, and organization of care. Generic key recommendations, with best available evidence, were selected from guidelines. A multidisciplinary panel of patients and medical professionals (n = 14) rated and prioritized these recommendations in a written procedure. Subsequently, the panel discussed the recommendations at a consensus meeting.

Results: Key recommendations were identified for communication (n = 32), physical support (n = 13), psychosocial care (n = 25), after-care (n = 11), and organization of care (n = 11). For all domains, recommendations based on high-level evidence were identified except for after-care and physical support. The panel developed 17 indicators concerning criteria for communication and informed consent, evaluation of communication skills, provision of information, examination of emotional health, appointment of a care coordinator, physical complaints, follow-up, rehabilitation, psychosocial effects of waiting times, and self-management.

Conclusions: A set of 17 indicators for patient-centered cancer care resulted from this study. Evidence support was available for most indicators.

Implications for Practice: This set provides an opportunity to measure and improve the quality of patient-centered cancer care. It is generic and therefore applies to many patients.

© 2012 Lippincott Williams & Wilkins, Inc.


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