1. “Best” Practices In Outcomes Research ISW 2013 Helsinki, Finland Christine Laronga MD FACS Comprehensive Breast Program H. Lee Moffitt Cancer Center

2. Renieri circa 1626

3. Rembrandt Circa 1606

4. Quality of Care Institute of Medicine report (1999): –Recommended monitoring quality of cancer care –Use a core set of quality of care indicators Closely related to outcomes Easily modifiable Provide clear guidance for quality improvement efforts Hewitt M. Institute of Medicine and National Research Council 1999

5. American Society of Clinical Oncology National Initiative for Cancer Care Quality (NICCQ) –Develop and validate a set of core process quality of care indicators –7 medical oncology groups Quality Oncology Practice Initiative (QOPI) –Conduct ongoing assessments of these indicators within individual practices –308 practice groups J Clin Oncol 2005 Sep1; 23 (25):6233-9. J Clin Oncol 2013 Apr 10; 31(11): 1471-7.

6. American College of Surgeons Commission on Cancer 1510 cancer programs National Cancer Data Base - registry 1 million new cases annually Primary use = retrospective evaluation of care

7. National Cancer Data Base

8. Florida Initiative for Quality Cancer Care: Consortium 2004 Jacobsen P. Journal of Oncology Practice 2007; 3: 60-65

9. Florida Initiative for Quality Cancer Care Gray JE. Journal of Oncology Practice 2011 Jul; 7(4): 247-51

10. Florida Initiative for Quality Cancer Care

11. Performing Outcomes Research High quality data Mechanisms to feed back the information to the participating practices or hospitals Systems to act upon the data Participation of providers Ongoing re-assessment Rayal MV. J Surg Oncol 2009 Jun 15; 99(8):488-90

12. “Best” Practices

13. Rapid Quality Reporting System

14. Commission on Cancer Add new standards for breast and colorectal Expand to other disease sites Increase adoption of the RQRS Expand public reporting of quality data Partnering with the LIVESTRONG foundation