Aim
The European quality assurance (QA) scheme for breast cancer services is a voluntary certification scheme in the context of organised, population-based breast cancer screening. It aims to support quality improvement and person-centred care in breast cancer services across Europe.
The scheme covers the entire breast cancer care pathway including screening, diagnosis, treatment and follow-up care and is available to all interested breast cancer services (e.g. hospitals, clinics, units, diagnostic centres, etc.) across diverse healthcare settings.
Description
The European QA scheme is a collection of requirements to support breast cancer services in improving the quality of care offered. Compliance with these requirements will be evaluated, whenever appropriate using several tools, including quantitative indicators.
The multidisciplinary panel Quality Assurance Scheme Development Group (QASDG) has defined the 'care pathway' from breast cancer screening to palliative care, the interventions and services to be considered, the quality domains to be included and how the scheme can be implemented at European level.
Certification to the scheme is underpinned by the European legislative framework on accreditation (defined in Regulation (EC) No 765/2008) and is recognised and accepted on a European and international level.
Approach
The requirements were defined and selected in a structured way by all QASDG members.
The procedure consisted of the following essential steps:
1. Collection of requirements
Requirements for all breast cancer care processes (from screening to follow-up and palliative care) were researched in existing literature, guidelines, indicator databases and quality assurance schemes, and were presented with reference to their evidence. In cases where the requirements retrieved did not address all the relevant quality potentials in the breast cancer care pathway, the QASDG developed new ones. Requirements that did not meet predefined inclusion criteria are excluded.
2. Panel process
In Delphi-style rounds, requirements were first rated for their understandability and relevance and subsequently for their feasibility. Relevance relates to the significance of the requirements for a patient-centred care outcome. Feasibility relates to the potential for practical implementation of the requirements across services in Europe and to provide meaningful data at service-provider level.
Only requirements that are rated high for understandability, relevance and feasibility by the majority of the QASDG members were included in the European QA scheme.
3. Feasibility and pilot run
The requirements were tested in real settings and the scheme was evaluated in a pilot exercise. They were amended based on the feedback gathered and implemented within the scheme.
Next steps
The updating round of the scheme will be initiated to keep the scheme up-to-date.