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National Consortium of Breast Centers, Inc. Quality Indicators For Which Each Quality Breast Center Type* Should Be Able to Measure Performance
* Breast Center DefinitionThe treatment of breast diseases including the
screening, diagnosis, and
treatment of breast cancer require the interaction of multiple
specialists in multiple departments. These include,
but are not limited to, surgery, medical oncology, radiation oncology,
radiology, pathology, plastic surgery, physical therapy, behavioral
medicine and nursing. Breast centers may provide a full complement of services to encompass all needs of the breast patient or may focus on specific portions of care such as imaging or surgical care. Breast centers may have all their services available under one roof, or may be a “center without walls,” organizing their services located at different locations under unified leadership. For services to be considered as “provided” services by the breast center, the center must maintain “quality control” of that service. Other services available without “quality control” are considered “referred” services. (See footnote below). Breast Center Types Breast Centers vary in many ways. We classify breast centers using two main variables: 1) breast center
profile characteristics and After these two variables have been clearly defined, centers can be separated into five types: a) Screening
Breast Center 1) Breast Center Profile Characteristics: These would include the size of their breast cancer treatment facility/hospital, size of the community they serve, volume of breast cancer patients seen, number of mammograms performed annually, patient characteristics, regional location and provider compensation structure. These characteristics will aid centers to compare themselves with similarly structured centers. 2) Components of Service: Depending on the type of breast center, breast centers offer varied services. We distinguish the types of breast centers by the components of service “provided” by that center (with quality control) not by the components of service available. In order for a center to be considered “providing” a component of service, they must have “quality control” of that component of service. Quality control of a service occurs 1) if there is data to review of that service AND 2) if the center can impact the type of care provided. (See definitions below) Definitions “Quality Control” means 1) there is quantitative data of that component of service available to the center AND 2) the breast center has the direct ability to modify that component of service (procedural influence not complete control). This allows the center to have quality monitoring and influence on the services they provide. “Provided” components of service are those for which the breast center has “quality control.” The location of those components of service does not impact the definition of “provided” services as long as quality control exists. Services may occur “on-site” or locally “off-site.” “Referred” components of service are performed without “quality control” by the center. This means the center does not have BOTH quantitative data AND direct ability to modify that component of service. Services are “referred” to outside vendors who may not readily share quality information or allow influence on their services. Footnote: The type of center viewed by the NQMBC program is based upon only services provided for which there is quality control by that center. The type of breast center viewed by patients is usually based upon services both provided and referred by that center. Therefore, a center may be viewed by the public as one type and viewed by the NQMBC program as another. |