360 Health Analysis (H360)—A Comparison of Key Performance Indicators in Breast Cancer Management across Health Institution Settings in Portugal
I. RêgoSara CoelhoP. SemedoJoana Cavaco‐SilvaLaetitia TeixeiraSusana SousaJoana ReisRui DinisFernando SchmittNoémia AfonsoJosé Luís FougoFrancisco PavãoRicardo Baptista LeiteLuís Costa
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Background: The increased focus on quality indicators (QIs) and the use of clinical registries in real-world cancer studies have increased compliance with therapeutic standards and patient survival. The European Society of Breast Cancer Specialists (EUSOMA) established QIs to assess compliance with current standards in breast cancer care. Methods: This retrospective study is part of H360 Health Analysis and aims to describe compliance with EUSOMA QIs in breast cancer management in different hospital settings (public vs. private; general hospitals vs. oncology centers). A set of key performance indicators (KPIs) was selected based on EUSOMA and previously identified QIs. Secondary data were retrieved from patients’ clinical records. Compliance with target KPIs in different disease stages was compared with minimum and target EUSOMA standards. Results: A total of 259 patient records were assessed. In stages I, II, and III, 18 KPIs met target EUSOMA standards, 5 met minimum standards, and 8 failed to meet minimum standards. Compliance with KPIs varied according to the type of hospital (particularly regarding diagnosis) and disease stage. Although small differences were found in KPI compliance among institutions, several statistical differences were found among treatment KPIs according to disease stage, particularly in stage III. Conclusions: This study represents the first assessment of the quality of breast cancer care in different hospital settings in Portugal and shows that, although most QIs meet EUSOMA standards, there is room for improvement. Differences have been found across institutions, particularly between oncology centers and general hospitals, in diagnosis and compliance with KPIs among disease stages. Stage III showed the greatest variability in compliance with treatment KPIs, probably related to the lower specificity of the guidelines in this disease stage.Keywords:
Performance indicator
CTによる膀胱腫瘍浸潤度判定をより客観的なものとする目的で, 新たに理想膀胱外壁線および腫瘍根部径 (W)-縦径 (H) 比を設定して各浸潤度別に比較検討し, 以下の検討結果をえた. (1) CTによる形態診断で, 小乳頭状型, 乳頭状有茎性型, 乳頭状無茎性型を示したものはすべて Stage B1以下であつた. 広基結節型を示した23例中19例は, CTによる判定通り広基結節型 Stage B2以上であつたが, 残りの4例は摘出標本では乳頭状無茎性型 Stage B1であつた. (2) 体位変換時の腫瘍変位性は, 乳頭状有茎性型形態を示したもののみに認められ, そのすべてが Stage B1以下であつた. (3) 理想膀胱外壁線外への腫瘍突出は広基結節型を示した Stage C 以上の全例に認められた. また, 従来膀胱壁外には突出しないとされてきた Stage B2の6例中4例に認められた. 突出した腫瘍根部の外壁を比較すると Stage B2ではその突出部の性状は平滑であつたが, Stage C 以上の場合は不整であつた. (4) W/H比に関しては, 乳頭状型を呈した Stage B1以下と広基結節型を呈した Stage B2以上は1.2で明瞭に判別できた.以上より作成したCTによる膀胱腫瘍浸潤度判定基準により, Stage B1以下では37例中26例 (70%), Stage B2以上では19例中16例 (84%). 特に膀胱内注入物質として空気を用いた場合, Stage B2以上において15例中15例 (100%) と非常に高い一致率が得られた.本判定基準による膀胱腫瘍浸潤度のCT診断は, 従来は極めて困難であつた深層浸潤性腫瘍の各 Stage の判別診断を可能とし, 臨床上極めて有用なものと考える.
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The implementation of key performance indicators (KPIs) is a challenging task for many businesses. Yet, effective implementation of KPIs is among the major determinants of performance and success of an organization. This study explored the new strategic thinking in mitigating the challenges in implementing key performance indicators (KPIs) and increasing efficiency in corporate performance management in the Middle East & North Africa (MENA) region. The study sought to test three hypotheses: (i) there is a significant relationship between having enough training and awareness sessions before implementation and effective implementation of KPIs; (ii) there is a significant relationship between having KPI professionals and specialists and effective implementation of KPIs; and (iii) there is a significant relationship between having clear KPI goals and objectives, on one hand, and the effective implementation of KPIs on the other. Hypotheses 2 and 3 were proved to be true while results for hypothesis 1 were inconclusive. A total of 1007 participants from across the MENA region were involved in the study. The findings demonstrate the importance of having clear KPI goals and objectives and KPI professionals or specialists to oversee the KPI selection and implementation process. Further research should be conducted to establish whether there is a significant relationship between having enough training and awareness sessions before implementation and effective implementation of KPIs.
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Management performance measurement based on Key Performance Indicators (KPIs) has been widely applied in any organization. This paper aims to identify Key Performance Indicators (KPIs) and classify them based on performance measurements to improve optimal management organizational performance. This research is based on a literature review of 50 journals based on performance management with the weight of Key Performance Indicators (KPIs) for the years 2011-2020. Performance measurement using this Key Performance Indicator can be implemented in many institutional organizations such as industry company sector, services, academics, hospitals, and government. KPIs can change behavior in an organization and provide results in broad contexts such as improving business results or driving improved operational performance. KPIs also help in implementing performance measurement on an ongoing basis. So that KPIs become a better way of managing the organization.
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地方性甲状腺腫は臨床, 病理学的に複雑な経過を示し, 疫学的, 病理学的発生論や治療の選択に多くの難題が残されている. 著者は本症の病期検討および妥当な病期分類がこれらの検索, 解明にきわめて有用であると着目し, 甲状腺剔出を行なった地方性甲状腺腫336例を臨床, 病理学的に精査し下記の結果をえた. 1) 地方性甲状腺腫は臨床的, 病理学的経過からStage 1;過形成期, Stage 2;腫大期, Stage 3;結節形成期と分類できた. 2) 本症は病期の進行に伴い病悩期間は長くなり, 甲状腺腫は増大し種々の局所圧迫症状をみるが, 合併症がなければ全身的, 臨床生化学的所見はほぼ正常である. 3) 臨床, 病理学的に本症はStage 1からStage 2さらにStage 3に進行し, Stage 3は終末期である. 4) 病変の占居部位はStage 1では両葉性, Stage 2では両葉性と単葉性がほぼ等しく, Stage 3では単葉性が多い点からもStageの進行度を裏付けられる. 5) 336例のうち男性39例, 女性297例, 男女比1:7.6で, 発生のピークは女性では20才から30才代, 男性は30才から40才代であった. 6) 手術適応例は若年者より成人に多く, 女性は男性より著しく多い. ヨード治療の効果が若年者ほど良好で, 男性は女性よりもヨード感受性が高いためである. 7) Stage 3の9.4%に甲状腺機能亢進症 (4.03%), 腺腫 (1.34%), 甲状腺癌 (4.03%) などの共存疾患がみられた. 8) ヨード治療はStage 1では効果的であるがStage 2では無効でStage 3に進行し, 種々の合併症を起こすこともあり, Stage 2における手術が望ましい.
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This chapter explores how the four types of performance measures differ with examples of each type. These four measures are in two groups: result indicators and performance indicators. Key result indicators (KRIs) give the board an overall summary of how the organization is performing. Result indicators (RIs) tell management how teams are combining to produce results. Performance indicators (PIs) tell management what teams are delivering. Key performance indicators (KPIs) are those indicators that focus on the aspects of organizational performance that are the most critical for the current and future success of the organization. Many management books that cover KPIs talk about lead and lag indicators; this merely clouds the KPIs debate. The RIs and PIs will be reported in various time frames from daily, weekly, and fortnightly to monthly. The KRIs, which are best used to report performance to the board, will, therefore, be based around the timing of the board meeting.
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This chapter defines indicators in general, and key performance indicators (KPIs) and key risk indicators (KRIs) specifically. It explores KPIs in greater depth and looks at the role of risk measurement and reporting in enterprise risk management (ERM). The chapter concerns the task at hand: creating effective KRIs that a company can use to anticipate future risks. It elaborates on how best to implement a KPI/KRI program within an ERM framework. KPIs are indicators used to determine how well the company is performing against its business goals. KRIs show how much risk is associated with a specific activity or investment. KPIs fall into two broad categories: internal and external. The first step in implementing an effective key indicators program is to define business strategy and objectives, as well as specific performance targets and risk tolerances. One of the most important things to keep in mind while developing KPIs and KRIs is the role of stakeholders.
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Key Performance Indicators (KPIs) are important for monitoring the performance in the industry. They can be used to identify poor performance and the improvement potential. KPIs can be defined for individual equipment, sub-processes, and whole plants. Different types of performances can be measured by KPIs, for example energy, raw-material, control & operation, maintenance, etc. Benchmarking KPIs with KPIs from similar equipment and plants is one method of identifying poor performing areas and estimating improvement potential. Actions for performance improvements can then be developed, prioritized and implemented based on the KPIs and the benchmarking results. An alternative to benchmarking, which is described in this paper, is to identify the process signals that are strongest correlated with the KPI and then change these process signals in the direction that improves the KPI. This method has been applied to data from a combined heat and power plant and a suggestion are given on how to improve boiler efficiency.
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