Development of a benchmark tool for Comprehensive Cancer Centers: Results from a pilot exercise.

Background: The BENCH-CAN project is an international benchmarking project which aims to develop a tool for the benchmarking of comprehensive cancer care and yield good practice examples across the EU in a way that contributes to improve the quality of interdisciplinary patient treatment. The Joint Commission defines benchmarking as “a systematic, data-driven process of continuous improvement that involves internally and/or externally comparing performance to identify, achieve, and sustain good practice”. This paper describes the development and results of a pilot of an institutional tool at 5 cancer centers. Methods: The 13 step benchmarking process by Van Lent et.al. was used. A framework based on the European Foundation of Quality Management model and the Institute of Medicine domains of quality was developed to structure the indicators. Indicators were primarily derived from literature and secondary from expert opinion. Centers provided data and a site visit was performed to grasp the context and to clarify additional questions. Based on the results of the pilot good practices were defined. Results: The final indicator list contains 81 qualitative and 141 quantitative indicators. Centers reported the data in the same way which enables comparison.Differences between pilot sites are found in for example length of stay (5 to 9 days), and staff turnover rates (for nurses it varied from 0,46% to 25,5%). Another difference can be found in the domain of Resources such as IT (for example the storage of patient records which was done digitally in some centers, but on paper in others), and patient involvement both in their own care process, as in the strategy development of an institute. Conclusions: A benchmarking tool for Comprehensive Cancer Care has been developed that will become available in an open format. Variation of the results provided improvement opportunities for all centers. Reliability and validity of the tool are ensured by the pilot of the indicators at 5 cancer centers. The pilot showed that the sites all reported data in the same way and all provided the type of data that was required. Apart from this institutional benchmark, a pathway benchmark was developed as well as a consumer experience questionnaire.