Compliance with LN staging recommendations has improved, but inconsistently.
In 2005 the PCA distributed regional performance data to hospital CEOs and Chiefs of Surgery, including compliance with CRC LN staging recommendations.
However, compliance with staging recommendations may not be achievable in all patients given confounding factors such as physiology, comorbid conditions, cancer stage, and tumor location.
In particular, lack of organizational infrastructure to coordinate and monitor changes in practice, and support multidisciplinary interaction may have limited the response to CRC LN staging recommendations.
When asked how they learned about the LN staging recommendations surgeons and pathologists across all intervention groups (20/26, 77%) cited the educational presentation.
All subjects, if applicable, were assigned a stage following in detail Braak staging recommendations and a McKeith neuropathological category following in detail recommendations by the consortium on DLB international workshop [ 4, 28].
As per the AJCC staging recommendations, when insufficient information is available to determine the N staging subcategory at the time of reporting a primary melanoma, these should be recorded with an "x" (ie, Nx).
Otherwise, most surgeons and pathologists were unaware of whether they were meeting LN staging recommendations – I don't have any idea how successful we are in achieving that goal (S542).
Use of an exploratory approach provided an in-depth view of the way that numerous factors amenable to quality improvement influenced the adoption of new CRC LN staging recommendations.
The purpose of this study was to examine how various factors influenced the outcome of different interventions implemented to increase compliance with LN staging recommendations, identify how this practice could be further improved, and generate knowledge on the structures and processes required in health delivery organizations to better adopt innovative clinical practices.
