Improving surgical performance for early stage breast cancer across multiple institutions

Update Item Information
Title Improving surgical performance for early stage breast cancer across multiple institutions
Publication Type thesis
School or College School of Medicine
Department Biomedical Informatics
Author Nkoy, Flory L.
Date 2005-12
Description Lumpectomy (Breast Conserving Surgery - BCS) followed by radiation therapy provides survival benefit identical to that of mastectomy for early stage breast cancer. Yet BCS is still underutilized and its use varies significantly among hospitals. The purpose of the project was to decrease variation and increase the frequency of BCS across multiple Intermountain Health Care (IHC) facilities, and to sustain this improvement over time. The study methods involved 1) Identification of the outcome measure, data sources and required data elements; 2) Standardization of data collection processes across IHC facilities; 3) Collection and integration of required data elements from local cancer registries into a central database; 4) Development of performance profiling reports from the central database; 5) Implementation of feedback interventions to surgeons and evaluation of the frequency of BCS following these interventions. The results of the study revealed that before the implementation of feedback interventions (1998-2001), the average frequency of BCS was 53% at IHC facilities. After the implementation of feedback (2001), the frequency of BCS increased from 53% to 65% (p<0.001) and has remained elevated over 4 years (2002-2005). The respective frequencies of BCS at each facility also increased after the implementation of feedback. The difference between facility was the lowest frequency and facility with the highest frequency decreased from 35% (74%-39%) to 16% (75%-59%), a decrease of 53% in variation. In summary, integrated data from local cancer registries, the use of central performance reporting and feedback interventions resulted in a decreased variation and a sustained increase in the use of BCS across multiple facilities.
Type Text
Publisher University of Utah
Subject Intermountain Health Care (Utah); Breast - Cancer - Surgery - Utah; Breast - Cancer - Surgery - Idaho; Medical informatics - Utah; Medical informatics - Idaho
Subject MESH Breast Neoplasms; Medical Informatics; Surgery; Surgery, Plastic; Surgical Procedures, Operative
Dissertation Institution University of Utah
Dissertation Name MS
Language eng
Relation is Version of Digital reproduction of "Improving surgical performance for early stage breast cancer across multiple institutions". Spencer S. Eccles Health Sciences Library.
Rights Management © Flory L. Nkoy.
Format application/pdf
Format Medium application/pdf
Format Extent 1,038,894 bytes
Identifier undthes,4362
Source Original: University of Utah Spencer S. Eccles Health Sciences Library (no longer available).
Master File Extent 1,038,991 bytes
ARK ark:/87278/s6k939cp
Setname ir_etd
ID 191539
Reference URL https://collections.lib.utah.edu/ark:/87278/s6k939cp
Back to Search Results