Assuring quality in cancer care: A challenging multidisciplinary responsibility

Abstract

With the increasing possibilities and complexity of oncology care, patient care more and more becomes a multidisciplinary responsibility. Therefor it is important to enable integrated multidisciplinary evaluation of this care.

Part I of this dissertation provides insight in the development of Clinical Audits to evaluate quality of multidisciplinary oncological care and to catalyse both local and national improvements. Core principles, initiation and development, first results and lessons that can be learned from the development of the first national -multidisciplinary- audits are described. Also, the conditions that must be taken into account to generate meaningful information were examined.

Part II is focussed on the variation in multimodal treatment strategies between hospitals. For the latter two pre-eminently multidisciplinary treated types of cancer highlighted: lung and stomach cancer. Various methods were applied using pre-existing audit data, performing an in-depth investigation with in-hospital medical records and a qualitative approach with semi-structured interviews.