Hepatobiliary and pancreatic cancer quality performance indicators: consultation review

Appendix 1: QPI Development Process

Preparatory Work and Scoping
The preparatory work involved the development of a structured briefing paper by Healthcare Improvement Scotland. This paper took account of existing, high quality, clinical guidance and provided a basis for the development of QPIs.

The scope for development of HPB Cancer QPIs and a search narrative were defined and agreed by the HPB Cancer QPI Development Group. The table below shows the final, inclusion and exclusion criteria used in the literature search.

Table 1: HPB Literature Search Criteria

A systematic search was carried out by Healthcare Improvement Scotland using selected websites and two primary medical databases to identify national and international guidelines.

Twenty seven guidelines were appraised for quality using the AGREE II instrument. This instrument assesses the methodological rigour used when developing a guideline. Six of the guidelines were not recommended for use. Of the remaining 21 guidelines, 12 were unreservedly recommended for use and 9 were recommended for use with consideration of their applicability or currency.

Indicator Development

The HPB QPI Development group defined evidence based, measurable indicators with a clear focus on improving the quality and outcome of care provided.

The Group developed QPIs using the clinical recommendations set out in the briefing paper as a base, ensuring all indicators met the following criteria:

• Overall importance - does the indicator address an area of clinical importance that would significantly impact on the quality and outcome of care delivered?
• Evidence based - is the indicator based on high quality clinical evidence?
• Measurability - is the indicator measurable i.e. are there explicit requirements for data measurement and are the required data items accessible and available for collection?

Engagement Process

A wide clinical and public engagement exercise was undertaken as part of development in April 2012 where the HPB Cancer QPIs, along with accompanying draft minimum core dataset and measurability specifications, were made available on the Scottish Government website. During the engagement period clinical and management colleagues from across NHSScotland, patients affected by HPB cancer and the wider public were given the opportunity to influence the development of HPB Cancer QPIs.

Draft documentation was circulated widely to professional groups, health service staff, voluntary organisations and individuals for comment and feedback.

Following the engagement period all comments and responses received were reviewed by the HPB Cancer QPI Development Group and used to produce and refine the final indicators.