Clinical pathways in oncology have become increasingly complex, involving several different healthcare professionals inside and outside the hospital setting who need particular coordination to provide appropriate care for patients. Very few QI exist to evaluate the oncological clinical pathway in its entirety, particularly regarding the various stages between patient admissions and discharges and the liaisons with non-hospital healthcare professionals (e.g. GPs, pharmacists). Our objective is to select a number of QI describing the oncological clinical pathway with an expert panel.
A systematic review of available QI describing the oncological clinical pathways in the literature was conducted. The list of selected QI was presented to an expert panel (oncologists, pharmacists and SRNs) of various hospitals in France. The selection involved a two-step process: a preliminary selection was conducted based on the title and rationale of the QI by consensus (nominal group), assigning a value to each QI reviewed on the basis of its appropriateness and its feasibility (1st working group). The pre-selected QI were then described in detail and presented to the expert panel (2nd working group) in order to validate the selection.
5731 QI were identified in the literature review and 131 included. 17 indicators were pre-selected by the experts (1st working group). After presentation of the 17 detailed descriptors, the QIs were clustered or eliminated. Ultimately, 10 QI were selected (Table): outcome (2), process (3) and structure (5).Table: 1658P
|1||Symptoms and disease progression||Structure|
|2||Assessment of tolerance to treatment||Process|
|3||Management of patients receiving oral therapy||Structure|
|4||Quality of the liaison document||Process|
|5||Composite score for supportive care||Structure|
|6||Patient therapeutic education||Structure|
|9||Declaration and follow-up upon serious adverse events in clinical pathway||Structure|
|10||Patient’s experience (PREMS)||Outcome|
This approach will be developed further by presenting the IQs to patient associations and primary care physicians in order to gather their feedback, refine, adapt and ultimately create a representative set of indicators.
Clinical trial identification
Legal entity responsible for the study
Novartis Oncology France.
All authors have declared no conflicts of interest.