Top

Strahlentherapie und Onkologie

Published in:

01-02-2014 | Original article

The QUIRO Study (assurance of quality and innovation in radiooncology): methodology, instruments and practices

Authors: J. Dunst, N. Willich, H. Sack, R. Engenhart-Cabillic, V. Budach, Dr. W. Popp

Published in: Strahlentherapie und Onkologie | Issue 2/2014

Abstract

Purpose

The QUIRO study aimed to establish a secure level of quality and innovation in radiation oncology. Over 6 years, 27 specific surveys were conducted at 24 radiooncological departments. In all, 36 renowned experts from the field of radiation oncology (mostly head physicians and full professors) supported the realization of the study.

Methods

A salient feature of the chosen methodological approach is the “process” as a means of systematizing diversified medical–technical procedures according to standardized criteria. On the one hand, “processes” as a tool of translation are adapted for creating and transforming standards into concrete clinical and medical actions; on the other hand, they provide the basis for standardized instruments and methods to determine the required needs of physicians, staff, and equipment. In the foreground of the collection and measurement of resource requirements were the processes of direct service provision which were subdivided into modules for reasons of clarity and comprehensibility. Overhead tasks (i.e., participation in quality management) were excluded from the main study and examined in a separate survey with appropriate methods.

Results

After the exploration of guidelines, tumor- or indication-specific examination and treatment processes were developed in expert workshops. Moreover, those specific modules were defined which characterize these entities and indications in a special degree. Afterwards, these modules were compiled according to their time and resources required in the “reference institution”, i.e., in specialized and as competent recognized departments (mostly from the university area), by various suitable survey methods.

Conclusion

The significance of the QUIRO study and the validity of the results were optimized in a process of constant improvements and comprehensive checks. As a consequence, the QUIRO study yields representative results concerning the resource requirement for specialized, qualitatively and technologically highly sophisticated radiooncologic treatment in Germany

Blank E, Willich N, Fietkau R et al (2012) Evaluation of time, attendance of medical staff, and resources during radiotherapy for breast cancer patients. Strahlenther Onkol 188:113–119PubMedCrossRef

Budach W, Bölke E, Fietkau R et al (2011) Evaluation of time, attendance of medical staff, and resources during radiotherapy for head and neck cancer patients: the DEGRO-QUIRO trial. Strahlenther Onkol 187:449–460PubMedCrossRef

Davenport TH, Short JE (1990) The new industrial engineering, information technology and business process redesign. Sloan Manage Rev 31:11–27

De Luc K (2001) Developing care pathways—the handbook. Oxford

European Association of Business Process Management (2009) Business process management. Gießen

Fietkau R, Budach W, Zamboglou N et al (2012) Time management in radiation oncology: development and evaluation of a modular system based on the example of rectal cancer treatment. Strahlenther Onkol 187:5–11CrossRef

Harkleroad A, Schirf D, Volpe J et al (2000) Critical pathway development: an integrative literature review. Am J Occup Ther 54(2):148–154PubMedCrossRef

Institute of Physics and Engineering in Medicine (2002) Guidelines for the provision of a physics service to radiotherapy. IPEM document

International Atomic Energy Agency (2008) Setting up a radiotherapy program, clinical, medical physics, radiation protection and safety aspects. IAEA, Austria

10.

Johanson HJ, McHugh P, Pendlebury AJ, Wheeler WA II (1993) Business process reengineering, breakpoint strategies for market dominance. Chichester

11.

Katterhagen G (1996) Physician compliance with outcome-based guidelines and clinical pathways in oncology. Oncology 10(11):113–121PubMed

12.

Kobeissi BJ, Gupta M, Perez CA et al (1998) Physician resource utilization in radiation oncology, a model based on management of carcinoma of the prostate. Int J Radiat Oncol Biol Phys 40:593–603PubMedCrossRef

13.

Kohlbacher M (2010) The effects of process orientation, a literature review. Bus Process Manag J 16:135–152CrossRef

14.

Mazeron JJ, Mornex F, Eschwege F et al (2008) Qualité en radiothérapie, les actions de la société française de radiothérapie oncologique (SFRO), Increasing quality and safety of external radiation treatments, actions of the french society of radiation oncology (SFRO). Cancer Radiotherapy 12:601–605CrossRef

15.

Nathan RE, Hochman J, Becker R et al (2000) Critical pathways: a review. Circulation (AHA Scientific Statement) 101:461–465

16.

Panella M, Marchisio S, Di Stanislao F (2003) Reducing clinical variations with clinical pathways, do pathways work? Int J Qual Health Care 15:509–521PubMedCrossRef

17.

Portaluri M, Fucilli FI, Gianicolo EA et al (2010) Collection and evaluation of incidents in a radiotherapy department, a reactive risk analysis. Strahlenther Onkol 186:693–699PubMedCrossRef

18.

Purdy PW, Procter HD, Wasserman TW (1993) Cost accounting in radiation oncology, a computer-based model for reimbursement. Int J Radiat Oncol Biol Phys 25:895–906PubMedCrossRef

19.

Renholm M, Leino-Kilpi H, Suominen T (2002) Critical pathways: a systematic review. J Nurs Adm 32(4):196–202PubMedCrossRef

20.

Smith, TJ, Hillner BE (2001) Ensuring quality cancer care by the use of clinical practice guidelines and critical pathways. J Clin Oncol 11:2886–2897

21.

Swenson KD (2010) Mastering the unpredictable. Tampa

22.

Van Herck P, Vanhaecht K, Sermeus W (2004) Effects of clinical pathways: do they work? J Integr Care Pathw 8:95–105

23.

Vom Brocke J, Rosemann M (2010) Handbook on business process management, strategic alignment, governance, people and culture. Berlin

24.

Zabel-du Bois A, Milker-Zabel S, Henzel M et al (2012) Evaluation of time, attendance of medical staff, and resources during stereotactic radiotherapy/radiosurgery. Strahlenther Onkol 188:769–776CrossRef

25.

Zander K (2002) Integrated care pathways: eleven international trends. J Integr Care Pathw 6:101–107

Title: The QUIRO Study (assurance of quality and innovation in radiooncology): methodology, instruments and practices
Authors: J. Dunst
N. Willich
H. Sack
R. Engenhart-Cabillic
V. Budach
Dr. W. Popp
Publication date: 01-02-2014
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 2/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-013-0555-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The QUIRO Study (assurance of quality and innovation in radiooncology): methodology, instruments and practices

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2014

Effects of chemotherapy on the parotid and submandibular glands in head and neck cancer patients treated with chemoradiotherapy

Mitteilungen der Fachgesellschaften

Fractionated external beam radiotherapy of skull base metastases with cranial nerve involvement

Salvage prostate HDR brachytherapy combined with interstitial hyperthermia for local recurrence after radiation therapy failure

Berechnungen der „equivalent uniform dose“ zur akzelerierten Teilbrustbestrahlung mit dem MammoSite-Applikator

Patients who die during palliative radiotherapy