Safer cancer care for Ontarians

Today (May 17), the Cancer Quality Council of Ontario (CQCO) released the results of the 2017 Cancer System Quality Index (CSQI), an interactive web-based tool used to measure the performance of the cancer system in Ontario. The findings indicate that efficiencies, such as a reduction in unnecessary or duplicate testing, maximizing the use of radiation investments, and the creation of specialized cancer treatment centres to consolidate expertise, have improved patient outcomes and the safety of the cancer system, enabling greater capacity in the healthcare system.

“It’s important to measure areas of the system that need improvement,” said Virginia McLaughlin, Chair of the CQCO. “This year’s results demonstrate that Ontario continues to make progress in the safety indicators that we’re measuring, however, there is room for improvement. A better understanding of complications of care and supporting patients’ needs, during active treatment, would further improve patient experience and outcomes.”

Measuring what Matters

The CSQI found several improvements to safety this year within the cancer system. These improvements show how the system is responding to the benchmarks that are set for each indicator:

• Perforation during colonoscopies: Ontario is performing well when it comes to safety for diagnostic or therapeutic colposcopies. The rate of perforation within seven days of a procedure is well below Cancer Care Ontario’s target of less than 1 perforation per 1, 000 colonoscopies.
• Drug ordering for chemotherapy: Ontario has seen continuous improvement to the implementation of computerized prescriber drug ordering systems for chemotherapy. The implementation of Systemic Treatment Computerized Prescriber Order Entry has consistently increased since 2004. Computerized drug ordering systems have been shown to reduce errors for prescribed chemotherapy regimens from 15 percent to near zero.
• Peer review: Peer review among radiation oncologists across Ontario is also on the rise, increasing quality assurance and safety within the system. The overall Ontario average of curative cases being peer reviewed is 77 per cent, which exceeds the 2015/2016 target of 75 per cent. 

The Cancer Quality Council of Ontario encourages Cancer Care Ontario to continue its leadership in driving evidence and quality improvement across the system and recommends that it prioritize the responsive, integrated and efficient measures for future reporting by focusing on: improvements to real-time measures of patient experience and outcomes, coordination across transition points and optimizing resources based on evidence. Improving access to testing, screening and supportive services have been identified as priorities for Cancer Care Ontario to address moving forward.

"Cancer Care Ontario is committed to working with health system partners and patients to continually improve Ontario's cancer system so that it can be the best in the world for all Ontarians,” said Michael Sherar, President & CEO, CCO. “The CSQI helps us identify and keep a focus on those areas where improvements need to be made.”

The CSQI is a quality improvement tool which has been released annually since 2005 and identifies gaps in the cancer system, driving improvement through regional, provincial, national and international benchmarking. The CSQI evolves year-over-year, retiring indicators when performance reaches or surpasses targets, or when there is a more accurate way to measure the system. The CSQI informs Cancer Care Ontario’s overall action plan, helping to determine priorities and allocation of resources.

The 2017 CSQI reports on a total of 35 indicators spanning the continuum of cancer care from screening to survivorship, along with several measures related to cancer prevention.

Visit www.csqi.on.ca to review all the indicators and this year’s interactive reporting tool.