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ABSTRACT: Objectives
This study explored potential quality measures to improve skin cancer management in primary care settings, and the barriers and facilitators associated with their implementation.Design
Semistructured interviews and qualitative proforma surveys were conducted with skin cancer experts from a range of healthcare settings. Framework analysis was employed to identify key groups of quality measures within the domains of the Donabedian model of healthcare quality (structure, process, outcome). Interview and survey data were triangulated to identify common groups of quality measures, barriers and facilitators.Participants
We purposively recruited skin cancer experts from Australia and internationally with knowledge and experience in skin cancer management. The final sample consisted of 15 participants who had clinical or academic backgrounds.Results
Participants unequivocally expressed the need for quality measures to guide skin cancer care. Ten groups of quality measures were identified: three groups related to the structural elements of care (eg, diagnostic tools), four related to the processes of care (eg, diagnostic process) and three related to outcomes of care (eg, treatment outcomes). Implementation barriers included clinician resistance, system inadequacies and external factors (eg, patient risk). Facilitators included incentives, education, agreed and feasible indicators and support and guidance.Conclusions
To service a growing population of skin cancer patients in Australia, the role of primary care needs to be more clearly specified, and its care providers supported and more engaged in quality improvement processes. Structure, process and outcome quality measures, derived from detailed guidance for primary care settings, can be used to track practitioner performance and facilitate ongoing improvement.
SUBMITTER: Spanos S
PROVIDER: S-EPMC11243125 | biostudies-literature | 2024 Jul
REPOSITORIES: biostudies-literature
Spanos Samantha S Singh Nehal N Laginha Bela I BI Arnolda Gaston G Smith Andrea L AL Wilkinson David D Cust Anne E AE Braithwaite Jeffrey J Rapport Frances F
BMJ open 20240711 7
<h4>Objectives</h4>This study explored potential quality measures to improve skin cancer management in primary care settings, and the barriers and facilitators associated with their implementation.<h4>Design</h4>Semistructured interviews and qualitative proforma surveys were conducted with skin cancer experts from a range of healthcare settings. Framework analysis was employed to identify key groups of quality measures within the domains of the Donabedian model of healthcare quality (structure, ...[more]