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Torras MG, Canals E, Muñoz-Montplet C, Vidal A, Jurado D, Eraso A, Villà S, Caro M, Molero J, Macià M, Puigdemont M, González-Muñoz E, López A, Guedea F, Borras JM. Improving quality of care and clinical outcomes for rectal cancer through clinical audits in a multicentre cancer care organisation. Radiat Oncol 2020; 15:28. [PMID: 32005123 PMCID: PMC6995177 DOI: 10.1186/s13014-020-1465-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/14/2020] [Indexed: 01/25/2023] Open
Abstract
Introduction Colorectal cancer treatment requires a complex, multidisciplinary approach. Because of the potential variability, monitoring through clinical audits is advisable. This study assesses the effects of a quality improvement action plan in patients with locally advanced rectal cancer and treated with radiotherapy. Methods Comparative, multicentre study in two cohorts of 120 patients each, selected randomly from patients diagnosed with rectal cancer who had initiated radiotherapy with a curative intent. Based on the results from a baseline clinical audit in 2013, a quality improvement action plan was designed and implemented; a second audit in 2017 evaluated its impact. Results Standardised information was present on 77.5% of the magnetic resonance imaging (MRI) staging reports. Treatment strategies were similar in all three study centres. Of the patients whose treatment was interrupted, just 9.7% received a compensation dose. There was an increase in MRI re-staging from 32.5 to 61.5%, and a significant decrease in unreported circumferential resection margins following neoadjuvant therapy (ypCRM), from 34.5 to 5.6% (p < 0.001). Conclusions The comparison between two clinical audits showed improvements in neoadjuvant radiotherapy in rectal cancer patients. Some indicators reveal areas in need of additional efforts, for example to reduce the overall treatment time.
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Affiliation(s)
- M G Torras
- Clinical Management Department, Institut Català d'Oncologia, Barcelona, Spain.
| | - E Canals
- Radiation Oncology Department, Institut Català d'Oncologia, Girona, Spain
| | - C Muñoz-Montplet
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Girona, Spain
| | - A Vidal
- Quality and Results Department, Institut Català d'Oncologia, Girona, Spain
| | - D Jurado
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Girona, Spain
| | - A Eraso
- Radiation Oncology Department, Institut Català d'Oncologia, Girona, Spain
| | - S Villà
- Radiation Oncology Department, Institut Català d'Oncologia, Badalona, Spain
| | - M Caro
- Radiation Oncology Department, Institut Català d'Oncologia, Badalona, Spain
| | - J Molero
- Medical Physics and Radiation Protection Department, Institut Català d'Oncologia, Girona, Spain
| | - M Macià
- Radiation Oncology Department, Institut Català d'Oncologia, Hospitalet del Llobregat, Barcelona, Spain
| | - M Puigdemont
- Hospital Tumor Registry, Institut Català d'Oncologia, Girona, Spain
| | - E González-Muñoz
- Quality and Results Department, Institut Català d'Oncologia, Girona, Spain
| | - A López
- Cancer Prevention and Control Program, Institut Català d'Oncologia, Hospitalet del Llobregat, Barcelona, Spain
| | - F Guedea
- Radiation Oncology Department, Institut Català d'Oncologia, Barcelona, Spain
| | - J M Borras
- Department of Clinical Sciences, IDIBELL, University of Barcelona, Barcelona, Spain
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