Hospitals and medical centers partner to share quality data to improve breast cancer treatment

Oct 31 2009

The Metropolitan Chicago Breast Cancer Task Force has announced the 56 participating hospitals, medical centers and mammography providers that are partnering to share quality data in order to identify deficits and implement strategies to improve breast cancer screening and treatment and reduce breast cancer mortality disparities. The Task Force made the announcement at its third annual Report Back to the Community at St. Paul Church of God in Christ, a prominent African-American church on Chicago's South Side.

This represents 75 percent of all hospitals in Metropolitan Chicago, and 80 percent of the mammography screenings provided by hospitals, including academic medical centers and nearly all safety-net institutions. The initiative is an unprecedented level of cooperation by providers in a voluntary quality improvement project and represents a major commitment by healthcare organizations to eliminating breast cancer mortality disparities in Chicago.

The Chicago Breast Cancer Quality Consortium project, funded through a $1 million grant from the Susan G. Komen for the Cure, has been designated as a Patient Safety Organization (PSO) by the U.S. Department of Health and Human Services. The PSO is the first in the nation to be dedicated exclusively to improving breast health care and one of only a handful of PSOs in the country actively working on a project.

"Previously, it was difficult for healthcare organizations to share quality and outcomes data and talk across institutions," said Dr. David Ansell, Chicago Breast Cancer Quality Consortium steering committee member and chief medical officer, Rush University Medical Center. "We all know how we can improve ourselves, but it's only when we start sharing information, warts and all, across institutions that we can have regional impact on quality and safety."

Historically, healthcare providers have been reluctant to share quality data that may show quality deficits because of fear of legal discovery. To address this issue, Congress passed the Patient Safety and Quality Improvement Act of 2005. This law created a new designation of patient safety organization that receives special federal confidentiality protections to encourage the sharing of such sensitive data.

The mission of the Chicago Breast Cancer Quality Consortium is to bring healthcare providers together to share, in a confidential manner, quality data in the area of breast cancer screening and treatment in order to identify quality deficits and implement strategies to eliminate those deficits. The Consortium's goal is to eliminate the racial health disparity in breast cancer deaths in Chicago.

Studies conducted by the Sinai Urban Health Institute have shown that African-American women in Chicago are more than twice as likely to die of breast cancer compared to Caucasian women. The mortality rate for African American women is a shocking 116 percent higher than that of white women, compared to a 47 percent disparity nationally and 21 percent in New York.

"We already know that differences exist across institutions in the quality of breast cancer screenings and diagnosis, as well as in the timeliness of screenings and treatment," said Marie Rule Gilliam, MHSA, Executive Director of the Task Force. "The medical community has now come together to track and compare quality measures in these areas, so that women in Chicago can receive the best possible diagnosis and treatment and will have the best chance of beating breast cancer."

For the first year, expert advisory boards for both mammography and breast cancer treatment have selected quality measures to analyze based on published scientific literature and clinical guidelines established by national medical organizations. Each participating institution is now in the process of collecting this data for submission to the Consortium.

Once the aggregated data has been analyzed, findings will be reported back to institutions and a report card will be issued to the community. The report card will not disclose names of the institutions but will discuss the variability in quality and make quality improvement recommendations.

"The hypothesis driving this project is that differences in the quality of breast health care from institution to institution contribute to the differences in outcomes leading to lives lost, in particular in communities of color," said Anne Marie Murphy, PhD, Director, Chicago Breast Cancer Quality Consortium. "The formation of a PSO offers our health care partners a secure environment, protected by legal privilege and confidentiality, to freely share quality information about their institutions."

Task Force Calls for Full Funding of IBCCP

The Task Force also called on Governor Pat Quinn and the Illinois Legislature to provide adequate funding for the Illinois Breast and Cervical Cancer Program (IBCCP), which they said is grossly underfunded.

"In Illinois, 300,000 women are eligible for mammograms through the IBCCP program, but the program only has enough money to fund mammograms for 33,000, or only one in 10 women," said Barbara Akpan, Chair of the Chicago Chapter of the National Black Nurses Association and a breast cancer survivor. "That is just plain unacceptable. A regular mammogram can be the difference between life and death. Every woman has a right to breast cancer screening and treatment."

Last year, the program received $20.6 million and provided mammograms to 39,500 women. This year, the funding was cut to $17.1 million, so only 33,000 women can get mammograms. The Task Force unveiled posters and a slogan for the campaign, "A Right Not a Luxury" and is collecting signatures through an on-line petition drive at www.petitiononline.com/MCBCTF1/petition.html.

Grant Awarded to Third Community-Based Organization for Education and Outreach

The Task Force announced a $50,000 first-year grant to Breast Cancer Network of Strength for outreach to women in Chicago Latino communities. Their goal is to educate low-income, medically underserved women about the importance of breast health screening and early detection and to facilitate access to breast screening services. This grant was made possible through generous funding provided by Sanofi-Aventis.

The Task Force continues to provide similar funding to two other community-based organizations, announced last year with funding from the Avon Foundation Breast Cancer Crusade. The Amani-Trinity United Community Health Corporation has dispatched peer health educators to canvas communities on the South Side, providing information on breast cancer health. "Mammogram navigators" are working to identify women in need of mammograms and help navigate them through the complete process of breast cancer screening. Sisters Embracing Life receives funding to conduct outreach in Austin and West Garfield Park, hold support group meetings, provide counseling and referral services, conduct mammogram and screening education and deliver mammogram reminders.