New Benchmarking Tool for Measuring Implementation of Integrated Practice Units

Key Points

  • Integrated practice units (IPUs) are defined as highly coordinated, multidisciplinary care (including rehabilitation and supportive services) that can provide better value to patients by increasing efficiency and lowering costs.
  • Researchers found there was no clear, consistent strategy for developing and implementing IPUs.
  • The researchers recommend that cancer centers explore strategic organizational changes to allow for adequate staffing to both measure and improve their use of IPUs as part of their cancer pathways.

New research by Wind et al in JNCCN—Journal of the National Comprehensive Cancer Network explores a new approach for benchmarking cancer centers based on how successfully their organizational structures allow them to implement integrated practice units (IPUs). These IPUs are defined as highly coordinated, multidisciplinary care (including rehabilitation and supportive services) that can provide better value to patients by increasing efficiency and lowering costs. However, upon applying this 13-step measurement method to 7 cancer centers across Europe, the researchers found there was no clear, consistent strategy for developing and implementing IPUs.

“We found a wide range of IPU-development stages and characteristics for cancer pathways,” said Anke Wind, PhD, of the Department of Psychosocial Research and Epidemiology at the Netherlands Cancer Institute. “The sobering finding is that [they] are not very advanced in their IPU maturity.”

Findings

This study is part of the international benchmarking project known as BENCH-CAN. The new benchmarking tool comprises 51 qualitative indicators and 193 quantitative indicators based on existing literature and expert consensus. Those data were then collected for the year 2012 from the seven pilot cancer centers, all of which are current members of the Organisation of European Cancer Institutes (OECI). The analysis focused mainly on breast cancer pathways to ensure all of the centers involved were able to provide sufficient data for comparison. The research process included an in-person visit to each center to verify data and better understand context.

The researchers concluded with the recommendation that cancer centers explore strategic organizational changes to allow for adequate staffing to both measure and improve their use of IPUs as part of their cancer pathways.

“A more systematic deployment of IPU traits is advised when implementing value-based health care in oncology,” said Dr. Wind. The researchers will be following up with a project on achieving best possible cancer treatment outcomes in treatment pathways through benchmarking—known as the ABC-Benchmarking project—which is intended to further validate and develop the benchmark format in order to link outcomes data to benchmark characteristics.

“This work is an important step toward more consistent provision of guideline-directed care during and after cancer treatment,” said Kathryn Ruddy, MD, MPH, Director of Cancer Survivorship for the Department of Oncology, Mayo Clinic Cancer Center, and a member of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel for Survivorship.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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