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  • Measure Summary
  • NQMC:011132
  • Feb 2016

Head and neck cancer: proportion of patients with oral, pharyngeal or laryngeal cancer who are seen by a specialist speech and language therapist (SLT) before treatment.

NHS Scotland, Scottish Cancer Taskforce. Head and neck cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Feb. 33 p. [20 references]

View the original measure documentation External Web Site Policy

This is the current release of the measure.

Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the proportion of patients with oral, pharyngeal or laryngeal cancer who are seen by a specialist speech and language therapist (SLT) before treatment.

Note from the National Quality Measures Clearinghouse: This measure is part of the Cancer Quality Performance Indicators (QPIs) collection. For more information, including a complete list of QPI measure sets, please visit the Healthcare Improvement Scotland Web site External Web Site Policy.

Rationale

A speech and language therapist (SLT) who specialises in head and neck cancer should be available to work with every patient whose primary treatment disrupts the ability to speak, eat or swallow (National Institute for Health and Care Excellence [NICE], 2004). These patients should receive appropriate speech and language therapy to optimise residual swallow function and reduce aspiration (Scottish Intercollegiate Guidelines Network [SIGN], 2006).

Baseline assessments should be undertaken by a Specialist SLT and appropriate interventions to maintain functions before treatment should commence (SIGN, 2006).

Continued SLT input is important in maintaining voice and safe and effective swallow function following head and neck cancer treatment (NICE, 2004; SIGN, 2006; Paterson et al., 2009).

Assessment of voice, speech and swallowing of patients is very difficult to measure accurately therefore uptake is utilised within this Cancer Quality Performance Indicator (QPI) as a proxy for assessment. Although it will not provide an absolute measure of patient access to this procedure it will give an indication of access across NHS Boards and highlight any areas of variance which can then be further examined.

Evidence for Rationale

National Institute for Clinical Excellence (NICE). Improving outcomes in head and neck cancers: the manual. London (UK): National Institute for Clinical Excellence (NICE); 2004 Nov. 156 p. [3 references]

NHS Scotland, Scottish Cancer Taskforce. Head and neck cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Feb. 33 p. [20 references]

Paterson JM, McColl E, Carding PN, Kelly C, Wilson JA. Swallowing performance in patients with head and neck cancer: a simple clinical test. Oral Oncol. 2009 Oct;45(10):904-7. PubMed External Web Site Policy

Scottish Intercollegiate Guidelines Network (SIGN). Diagnosis and management of head and neck cancer. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2006 Oct. 90 p. (SIGN publication; no. 90).  [511 references]

Primary Health Components

Oral cancer; pharyngeal cancer; laryngeal cancer; speech and language therapist

Denominator Description

All patients with oral, pharyngeal or laryngeal cancer (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients with oral, pharyngeal or laryngeal cancer who are seen by a specialist speech and language therapist (SLT) before treatment (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence
  • A formal consensus procedure, involving experts in relevant clinical, methodological, public health and organizational sciences
  • One or more research studies published in a National Library of Medicine (NLM) indexed, peer-reviewed journal

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

The collection of data is piloted on a small number of patient records using a paper data collection form produced by Information Services Division (ISD). The aim is to identify any anomalies or difficulties with data collection prior to full implementation. At least one NHS board in each Regional Cancer Network participates in the pilot.

Evidence for Extent of Measure Testing

NHS Scotland. National cancer quality performance indicators: overview of development process. Edinburgh (Scotland): NHS Scotland; 2012 Dec. 7 p.

State of Use

Current routine use

Current Use

Internal quality improvement

National reporting

Public reporting

Measurement Setting

Ambulatory/Office-based Care

Hospital Outpatient

Professionals Involved in Delivery of Health Services

Physicians

Speech-language Pathologists

Least Aggregated Level of Services Delivery Addressed

Single Health Care Delivery or Public Health Organizations

Statement of Acceptable Minimum Sample Size

Unspecified

Target Population Age

Unspecified

Target Population Gender

Either male or female

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Case Finding Period

Unspecified

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
All patients with oral, pharyngeal or laryngeal cancer

Exclusions
Patients who refuse assessment

Exclusions/Exceptions

Patient factors addressed

Numerator Inclusions/Exclusions

Inclusions
Number of patients with oral, pharyngeal or laryngeal cancer who are seen by a specialist speech and language therapist (SLT) before treatment

Exclusions
Patients who refuse assessment

Numerator Search Strategy

Fixed time period or point in time

Data Source

Electronic health/medical record

Paper medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

External comparison at a point in, or interval of, time

External comparison of time trends

Internal time comparison

Prescriptive standard

Prescriptive Standard

Target: 90%

The tolerance within this target is designed to account for situations where patients require treatment urgently.

Evidence for Prescriptive Standard

NHS Scotland, Scottish Cancer Taskforce. Head and neck cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Feb. 33 p. [20 references]

Original Title

QPI 7 – specialist speech and language therapist access.

Measure Collection Name

Cancer Quality Performance Indicators (QPIs)

Measure Set Name

Head and Neck Cancer

Submitter

NHS Scotland - National Government Agency [Non-U.S.]

Scottish Cancer Taskforce - National Government Agency [Non-U.S.]

Developer

NHS Scotland - National Government Agency [Non-U.S.]

Scottish Cancer Taskforce - National Government Agency [Non-U.S.]

Funding Source(s)

Scottish Government

Composition of the Group that Developed the Measure

Head and Neck Cancer QPI Development Group

Financial Disclosures/Other Potential Conflicts of Interest

Unspecified

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2016 Feb

Measure Maintenance

The Cancer Quality Performance Indicators (QPIs) will be kept under regular review and be responsive to changes in clinical practice and emerging evidence. Formal reviews are conducted every 3 years and baseline checks each year.

Date of Next Anticipated Revision

2017 Nov

Measure Status

This is the current release of the measure.

Source(s)

NHS Scotland, Scottish Cancer Taskforce. Head and neck cancer clinical quality performance indicators. Edinburgh (Scotland): Healthcare Improvement Scotland; 2016 Feb. 33 p. [20 references]

Measure Availability

Source document available from the Healthcare Improvement Scotland Web site External Web Site Policy.

For more information, contact the Healthcare Improvement Scotland at Gyle Square, 1 South Gyle Crescent, Edinburgh, Scotland EH12 9EB; Phone: 0131 623 4300; E-mail: comments.his@nhs.net; Web site: www.healthcareimprovementscotland.org/ External Web Site Policy.

Companion Documents

The following is available:

  • NHS Scotland. National cancer quality performance indicators: overview of development process. Edinburgh (Scotland): NHS Scotland; 2012 Dec. 7 p. This document is available from the Healthcare Improvement Scotland Web site External Web Site Policy.

NQMC Status

This NQMC summary was completed by ECRI Institute on May 18, 2017.

Copyright Statement

No copyright restrictions apply.

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