Original Contribution Implementation of a Performance Improvement Initiative in Colorectal Cancer Care

Purpose: In the United States, colorectal cancer (CRC) is the third leading cause of cancer after breast and prostate cancer. Numerous improvement programs have been implemented to increase CRC screening rates, but few have focused on improv-ing the care and management of patients with a diagnosis of this malignancy. As national medical organizations focus on quality of care, efforts are necessary to provide clinicians the opportunity for self-assessment and methods for practice improvement. With this goal in mind, a national continuing medical education– certified performance improvement initiative was conceived. Methods: The initiative consisted of three stages: First, partic-ipants self-assessed their performance of predetermined topic measures through a review of patient charts. The topic areas included patient safety and supportive care, evidence-based surveillance, and evidenced-based treatment and were derived from current guidelines and other successful quality-improve-ment initiatives. Second, an actionable plan for practice improve-ment was developed in at least one of the three topic areas. Third, after a period of self-improvement, participants reas-sessed their performance of the same topic measures to deter-mine tangible changes in patient care. Results: A total of 540 patient charts were reviewed by 27 clinicians. Notable results showed large gains in areas of sup-portive care, such as quantitative pain assessments and emo-tional well-being evaluations, which traditionally have been a minor focus of other quality-improvement initiatives. Participants also showed tangible improvements in the performance of lead-ing measures of quality care. Conclusion: These findings support the need for continued efforts toward performance improvement in both established and emerging areas of CRC patient care