Appendix 1: QPI Development Process
Preparatory Work and Scoping
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 prostate cancer QPIs and a search narrative were defined and agreed by the Prostate Cancer QPI Development Group. The table below shows the final search criteria used in the literature search.
Table 1: Prostate Cancer Search Criteria
Date: 2005 or later
Topics: diagnosis, staging, management of non-metastatic (organ confined or locally advanced) and metastatic (advanced) disease, follow up
Topics: prevention, screening, palliative/end of life care
A systematic search was carried out by Healthcare Improvement Scotland using selected websites and two primary medical databases to identify national and international guidelines.
Thirty-four guidelines were appraised for quality using the AGREE II instrument.
The instrument assesses the methodological rigour and precision used when developing
a guideline. Seventeen of the guidelines were not recommended for use. Five of the guidelines were recommended for use and six recommended for use with modifications.
The Prostate 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?
A wide clinical and public engagement exercise was undertaken as part of development in 2011 where the Prostate Cancer QPIs, along with accompanying draft minimum core dataset and measurability specifications, were made available on the Scottish Government website.
During the engagement period clinical and management colleagues from across NHSScotland, patients affected by prostate cancer and the wider public were given the opportunity to influence the development of Prostate Cancer QPIs. Several different methods of engagement were utilised:
Professional groups, health service staff, voluntary organisations and individuals:
Wide circulation of the draft documentation for comment and feedback.
Patient representative groups:
Organised patient focus group sessions were held in conjunction with the Urological Cancer Charity ( UCAN) and The Prostate Cancer Charity.
Following the engagement period all comments and responses received were reviewed by the Prostate Cancer QPI Development Group and used to produce and refine the final indicators.
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