Journal of Healthcare Management - May/June 2013 - (Page 205)

How to Improve Breast Cancer Care Measurement and Reporting: Suggestions from a Complex Urban Hospital Ann Scheck McAlearney, ScD, Department of Family Medicine, The Ohio State University, Columbus; Jill Wellner, Veterans’ Affairs Connecticut Healthcare System, West Haven, Connecticut; and Nina A. Bickell, MD, Department of Health Evidence and Policy, Icahn School of Medicine at Mount Sinai, New York, New York E X E C U t i V E S U M M a r Y Increasing scrutiny of clinical data reporting by healthcare accrediting organizations is challenging hospitals to improve measurement and reporting, especially in the area of cancer care. We sought to explore barriers to breast cancer adjuvant treatment measurement and reporting to a hospital tumor registry (TR) and to identify opportunities to improve these processes. We conducted 31 key informant interviews with administrators and clinicians associated with a large urban hospital that treats a high volume of breast cancer patients. In this setting, up to 40 percent of early-stage breast cancer cases are treated by community-based oncologists, but reporting to the hospital’s TR has been problematic. We asked about barriers to treatment measurement and reporting and sought suggestions to improve these processes. We used deductive and inductive methods to analyze interview transcripts. We found seven management barriers to adjuvant treatment measurement and reporting: process complexity, limited understanding of TR reporting, competing priorities, resource needs, communications issues, lack of supporting information technologies (IT), and mistrust of management. The four facilitators of measurement and reporting we noted were increasing awareness, improving communications and relationships, enhancing IT, and promoting the value of measurement and reporting. Four factors deemed critical to successful improvements were organizational commitment, leadership support, resources, and communication. Organizations striving to improve cancer care quality must overcome key barriers, especially those involving gaps in understanding and communication. In practice, hospitals should make explicit efforts to educate physicians and administrators about the importance of treatment reporting and to improve communications between the hospital’s TR and physicians to ensure that needed adjuvant therapies are appropriately delivered. For more information about the concepts in this article, contact Dr. McAlearney at 205

Table of Contents for the Digital Edition of Journal of Healthcare Management - May/June 2013

Journal of Healthcare Management - May/June 2013
Interview with Thomas C. Dolan, PhD, FACHE, CAE, President and CEO, American College of Healthcare Executives
Equity in Care: Picking Up the Pace
How Might a Reforming U.S. Healthcare Marketplace Threaten Balance Sheet Liquidity for Community Health Systems?
Assessing the Productivity of Advanced Practice Providers Using a Time and Motion Study
A Positive Deviance Perspective on Hospital Knowledge Management: Analysis of Baldrige Award Recipients 2002–2008
How to Improve Breast Cancer Care Measurement and Reporting: Suggestions from a Complex Urban Hospital
The Fear Factor in Healthcare: Employee Information Sharing

Journal of Healthcare Management - May/June 2013