Gap analysis: a strategy to improve the quality of care of head and neck cancer patients

Background Continuing assessment of cancer care delivery is paramount to the delivery of high-quality care. Head and neck cancer patients are vulnerable to flaws in care because of the complexity of medical and psychosocial conditions. Objective To describe the use of a gap analysis and quality improvement interventions to maximize the coordination and care for patients with head and neck cancer. Methods The gap analysis was comprised of a thorough literature review to determine best practice in the management of head and neck cancer patients and data collection on the care provided at a cancer center. Data collection methods included a clinician survey, a process map, and a patient satisfaction survey, and baseline data from 2013. A SWOT (strengths, weaknesses, opportunities, threats) analysis was conducted, followed with quality improvement interventions. A re-evaluation of key data points was conducted in 2015. Results Through the clinician survey (n = 25 respondents) gaps in care were identified and included insufficient preoperative education, inefficient discharge planning, and delayed dental consultations. The patient satisfaction survey indicated overall satisfaction with the care received at the cancer center. The process mapping (n = 33 respondents) identified that the intervals between treatments did not always meet the best practice standards. The re-assessment revealed improvement with the process for nonsurgical patients by meeting the benchmark. The surgical cases revealed the interval between surgery and initiation of treatment was greatly improved, although it did not yet meet the benchmark. Limitations Small sample size Conclusions A gap analysis provides the structure to evaluate and improve cancer care services for head and neck cancer patients.