Brain and central nervous system cancer: clinical quality performance indicators - engagement document

Appendix 1: QPI Development Process

The preparatory work involved the development of a structured briefing paper by Healthcare Improvement Scotland. This paper took account of existing, high quality, clinical guidance and provided a basis for the development of QPIs.

The scope for development of Brain/CNS Cancer QPIs and a search narrative were defined and agreed by the Brain/CNS Cancer QPI Development Group. The table below shows the final search criteria used in the literature search.

Brain/CNS Cancer Search Criteria

Inclusion

Topics (population/patient): Brain and Central Nervous System (CNS) tumours, including:

• Glial tumours/gliomas (including: astrocytomas, oligodendrogliomas, ependymomas, medulloblastomas)
• Spinal cord tumours
• Pineal tumours
• Intracranial germ cell tumours
• Neuronal tumours

Topics (intervention):

• Diagnosis
• Staging
• Surgical management of disease
• Non-surgical management of disease (chemotherapy, radiotherapy, biological/targeted therapies; palliation e.g. management of seizures)

Adults only

Date: 2005 to present day

Language: English only

Exclusion

Topics:

Related cancers, including:

• Metastatic brain/CNS tumours
• Meningiomas
• Cranial nerve tumours
• Pituitary tumours
• Primary CNS lymphomas

Communication/information, end of life care, pain management, prevention, and screening.

Primary care diagnosis and referral.

Guidelines for the conduct of clinical trials (topic for generic QPI development).

A systematic search was carried out by Healthcare Improvement Scotland using selected websites and two primary medical databases to identify national and international guidelines.

Nine guidelines were appraised for quality using the AGREE II instrument²⁸. This instrument assesses the methodological rigour and precision used when developing a guideline. Two of the guidelines were not recommended for use. Seven of the guidelines were recommended for use.

Indicator Development

The Brain/CNS Cancer QPI Development group defined evidence based, measurable indicators with a clear focus on improving the quality and outcome of care provided.

The Group developed QPIs using the clinical recommendations set out in the briefing paper as a base, ensuring all indicators met the following criteria:

• Overall importance – does the indicator address an area of clinical importance that would significantly impact on the quality and outcome of care delivered?
• Evidence based – is the indicator based on high quality clinical evidence?
• Measurability – is the indicator measurable i.e. are there explicit requirements for data measurement and are the required data items accessible and available for collection?

Engagement Process

A wide clinical and public engagement exercise was undertaken as part of development in May 2013, where the Brain/CNS Cancer QPIs, along with accompanying draft minimum core dataset and measurability specification, were made available on the Scottish Government website. During the engagement period clinical and management colleagues from across NHSScotland, patient affected by Brain/CNS cancer and the wider public were given the opportunity to influence the development of Brain/CNS QPIs.

Draft documentation was circulated widely to professional groups, health service staff, voluntary organisations and individuals for comment and feedback.

Following the engagement period all comments and responses received were reviewed by the Brain/CNS Cancer QPI Development Group and used to produce and refine the final indicators.

Brain/CNS Cancer QPI Development Group Membership (2013)

Name: Hilary Dobson

Designation: Regional Lead Cancer Clinician (Chair)

Cancer Network/Base: WoSCAN

Name: Anne Addison

Designation: Audit Facilitator

Cancer Network/Base: SCAN (Western General Hospital, Edinburgh)

Name: Syed A. Al-Haddad

Designation: Consultant Neurosurgeon

Cancer Network/Base: NOSCAN (Aberdeen Royal Infirmary)

Name: Anthony Chalmers

Designation: Clinical Oncologist

Cancer Network/Base: WoSCAN (Beatson West of Scotland Cancer Centre)

Name: Susan Chivers

Designation: Audit / MDT Coordinator

Cancer Network/Base: WoSCAN (Southern General Hospital, Glasgow)

Name: Laurence Dunn

Designation: Consultant Neurosurgeon

Cancer Network/Base: WoSCAN (Southern General Hospital, Glasgow)

Name: Sam Eljamel

Designation: Consultant Neurosurgeon

Cancer Network/Base: NOSCAN (Ninewells Hospital, Dundee)

Name: Kirsten Forbes

Designation: Consultant Radiologist

Cancer Network/Base: WoSCAN (Southern General Hospital, Glasgow)

Name: Helen Gooday

Designation: Consultant in Rehabilitation Medicine

Cancer Network/Base: NOSCAN (Woodend Hospital, Aberdeen)

Name: Robin Grant

Designation: Consultant Neurologist

Cancer Network/Base: SCAN (Western General Hospital, Edinburgh)

Name: James Ironside

Designation: Consultant Pathologist

Cancer Network/Base: SCAN (Western General Hospital, Edinburgh)

Name: Jennifer Lee

Designation: Audit Facilitator

Cancer Network/Base: NOSCAN (Ninewells Hospital, Dundee)

Name: Hannah Lord

Designation: Clinical Oncologist

Cancer Network/Base: NOSCAN (Ninewells Hospital, Dundee)

Name: Kelly Macdonald

Designation: Project Manager

Cancer Network/Base: WoSCAN

Name: James MacKenzie

Designation: Consultant Pathologist

Cancer Network/Base: NOSCAN (Aberdeen Royal Infirmary)

Name: Mairi MacKinnon

Designation: Clinical Nurse Specialist

Cancer Network/Base: WoSCAN (Beatson West of Scotland Cancer Centre)

Name: Shanne McNamara

Designation: Clinical Nurse Specialist

Cancer Network/Base: SCAN (Western General Hospital, Edinburgh)

Name: Carol Marshall

Designation: Project Manager

Cancer Network/Base: WoSCAN

Name: Alison Mitchell

Designation: Consultant in Palliative Medicine

Cancer Network/Base: WoSCAN (Beatson West of Scotland Cancer Centre)

Name: Brian Murray

Designation: Principle Information Development Manager

Cancer Network/Base: ISD

Name: Lynn Myles

Designation: Consultant Neurosurgeon

Cancer Network/Base: SCAN (Western General Hospital, Edinburgh)

Name: Chris Myres

Designation: Assistant Service Manager

Cancer Network/Base: SCAN (Western General Hospital, Edinburgh)

Name: Shona Olson

Designation: Consultant Radiologist

Cancer Network/Base: NOSCAN (Aberdeen Royal Infirmary)

Name: Sharon Peoples

Designation: Clinical Oncologist

Cancer Network/Base: SCAN (Western General Hospital, Edinburgh)

Name: Roy Rampling

Designation: SANON Clinical Lead

Cancer Network/Base: Scottish Adult Neuro-Oncology Network (SANON)

Name: Margaret Ritchie

Designation: Clinical Nurse Specialist

Cancer Network/Base: NOSCAN/ (Aberdeen Royal Infirmary)

Name: Ally Rooney

Designation: ST4 General Adult Psychiatry

Cancer Network/Base: SCAN (Royal Edinburgh Hospital, Edinburgh)

Name: Willie Stewart

Designation: Consultant Pathologist

Cancer Network/Base: WoSCAN (Southern General Hospital, Glasgow)

Name: David Summers

Designation: Consultant Radiologist

Cancer Network/Base: WoSCAN (Western General Hospital, Edinburgh)

Name: Evelyn Thomson

Designation: Regional Manager (Cancer)

Cancer Network/Base: WoSCAN

Name: Antonia Torgeson

Designation: Consultant Pathologist

Cancer Network/Base: SCAN (Royal Infirmary of Edinburgh, Edinburgh)

Name: Alena Vasianovich

Designation: Audit Facilitator

Cancer Network/Base: NOSCAN (Aberdeen Royal Infirmary)

NOSCAN - North of Scotland Cancer Network

SCAN - South East Scotland Cancer Network

WoSCAN - West of Scotland Cancer Network