Certification of breast centres in Germany: proof of concept for a prototypical example of quality assurance in multidisciplinary cancer careReportar como inadecuado




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BMC Cancer

, 9:228

First Online: 14 July 2009Received: 11 December 2008Accepted: 14 July 2009DOI: 10.1186-1471-2407-9-228

Cite this article as: Brucker, S.Y., Bamberg, M., Jonat, W. et al. BMC Cancer 2009 9: 228. doi:10.1186-1471-2407-9-228

Abstract

BackgroundThe main study objectives were: to develop a set of requirements of comprehensive breast centres; to establish a nationwide voluntary certification programme for breast centres based on such requirements, a certified quality management system QMS, and scheduled independent, external audits and periodic recertification; and to demonstrate the general acceptance of such a certification programme with a view to introducing similar certification programmes for other major cancers.

MethodsBreast centres introduced a QMS and voluntarily participated in an external certification procedure based on guideline-derived Requirements of Breast Centres specifically developed for the application procedure, all subsequent audits and recertification. All data numbers of pending and successful applications, sites-centre, etc. were collected by a newly founded, independent organisation for certification of cancer services delivery. Data analysis was descriptive.

ResultsRequirements of Breast Centres were developed by the German Cancer Society DKG, the German Society of Senology DGS and other relevant specialist medical societies in the form of a questionnaire comprising 185 essential items based on evidence-based guidelines and the European Society of Breast Cancer Specialists- EUSOMA requirements of specialist breast units. From late 2002 to mid 2008, the number of participating breast centres rose from 1 to 175. As of mid 2008, 77% of an estimated 50,000 new breast cancers in Germany were diagnosed and treated at certified breast centres, 78% of which were single-site centres.

ConclusionNationwide voluntary certification of breast centres is feasible and well accepted in Germany. Dual certification of breast centres that involves certification of breast services to guideline-derived requirements in conjunction with independent certification of a mandatory QMS can serve as a model for other multidisciplinary site-specific cancer centres.

AbbreviationsAGO Arbeitsgemeinschaft Gynäkologische Onkologie DGGG Working Group on Gynaecological Oncology

BCS breast-conserving surgery

BCT breast-conserving therapy

DGGG Deutsche Gesellschaft für Gynäkologie und Geburtshilfe German Society of Obstetrics and Gynaecology

DFS disease-free survival

DGS Deutsche Gesellschaft für Senologie German Society of Senology

DKG Deutsche Krebsgesellschaft German Cancer Society

DKG-CSP DKG-commissioned certification service provider

DOC Deutsches Onkologie Centrum Holding GmbH German Oncology Centre Ltd.

EUSOMA European Society of Breast Cancer Specialists formerly: of Mastology

FAB Fachliche Anforderungen an Brustzentren Requirements of Breast Centres

FISH fluorescent in situ hybridisation

HER2-neu human epidermal growth factor receptor-2

ISO International Organization for Standardization

KTQ Kooperation für Transparenz und Qualität im Gesundheitswesen Cooperation for transparency and quality in health care

OAS overall survival

OT operating theatre

pN pathologically determined nodal status

pT pathologically determined tumour stage

pTis carcinoma in situ pathologically staged

QA quality assurance

QI quality indicator

QMS quality management system

R1 microscopically positive surgical margin

SNB sentinel node biopsy.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-9-228 contains supplementary material, which is available to authorized users.

Sara Y Brucker, Michael Bamberg, Rolf Kreienberg and Diethelm Wallwiener contributed equally to this work.

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Autor: Sara Y Brucker - Michael Bamberg - Walter Jonat - Matthias W Beckmann - Andreas Kämmerle - Rolf Kreienberg - Diethelm Wa

Fuente: https://link.springer.com/







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