Aim
Cancer care cost over $10 billion in Australia between 2015-2016, and with such considerable investment comes an obligation to ensure that the clinical care we deliver is of the highest possible standard. How cancer clinicians reflect on measuring and reporting the quality of their clinical work, and potential avenues for doing so, are not well understood.
Methods
A short online survey was emailed to a sample of 250 medical oncology clinicians, including advanced trainees and medical oncologists, exploring their perceptions, attitudes and understanding of the current measurement and reporting of quality in clinical practice.
Results
137/250 clinicians responded (54.8%), comprising advanced trainees (19%) and oncologists of varying degrees of experience: 0-5 years (32%), 6-10 years (18%), 10-20 years (20%) and >20 years (11%). The majority responded that the measurement of quality in oncology practice should be routine (92%), but less than half (42%) were involved in any effort at routine reporting of quality; frequently cited barriers being uncertainty as to how to measure quality (30%), time limitations (27%) and the fear that quality appraisals could be misappropriated (10%). The majority of respondents desired more feedback about their personal practice standards (92%) and/or that of their institution (89%). Respondents reported that they either never received any feedback (21%), or only received informal / ad hoc feedback from either senior colleagues or peers (50%).
Conclusion
Based on this emailed survey of a cross-section of Australian cancer specialists there are many barriers to measuring and reporting quality of care. Respondents valued quality measurement highly but reported minimal routine involvement in quality assurance projects. The majority of respondents desired further feedback regarding their individual performance and the performance of their institution. Ad hoc informal feedback from peers and senior colleagues provided guidance for some. Defining, measuring and reporting of quality indicators is an urgent need for the medical oncology workforce.