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Pancreatic Cancer Quality Performance Indicators

Pancreatic cancer quality performance indicators (QPIs) are used to improve the quality of cancer services and deliver better outcomes for people diagnosed with pancreatic cancer.

In Aotearoa, over 630 patients are diagnosed with pancreatic cancer each year, and the incidence (number of new cases) has increased for both Māori and non-Māori. 

Pancreatic cancer has a very low five-year survival rate of 12% and Māori are more likely to die from this cancer compared with non-Māori. In addition, improvements in patient outcomes appear to lag behind other high-income countries.

Te Aho o Te Kahu worked with the National Pancreatic Cancer Working Group (NPCWG) to develop the first Pancreatic Cancer Quality Improvement Monitoring Report 2023, which reports on pancreatic cancer care quality performance indicators (QPIs) using national collection data from years 2015 to 2019.

Quality Improvement Monitoring Report

The Pancreatic Cancer Quality Improvement Monitoring Report 2023 reports on nine QPIs important for improving pancreatic cancer treatment and patient outcomes.

Te Aho o Te Kahu expects districts (previously district health boards prior to the 1 July 2022 Health and Disability Sector Reforms) to review their performance and, where unwarranted variation is identified, investigate further using local data and take action to improve their performance and patient outcomes. The variations and inequities noted in our findings and discussed in this report will also help guide national cancer quality improvement activities.

The reported QPIs in the Pancreatic Cancer Quality Improvement Monitoring Report 2023 are:

  • PQI 01. Route to diagnosis: Proportion of people diagnosed with pancreatic cancer within 30 days of an emergency/acute admission to hospital.
  • PQI 06. Pancreatic resection: Proportion of people with pancreatic cancer who had a pancreatic resection.
  • PQI 07. Biliary drainage/stenting: Proportion of people with pancreatic cancer who had a biliary drainage procedure.
  • PQI 08. Tissue diagnosis: Proportion of people with pancreatic cancer who had a recorded tissue diagnosis.
  • PQI 09. Medical oncology review: Proportion of people with pancreatic cancer who were reviewed by a medical oncologist.
  • PQI 11. Radiation therapy: Proportion of people with pancreatic cancer who have received radiation therapy. 
  • PQI 15. Days alive and out of hospital: The median number of days alive and out of hospital 30 days after pancreatic resection for pancreatic cancer.
  • PQI 16. Post-operative mortality: Proportion of people with pancreatic cancer who died within 30 and 90 days of pancreatic resection.
  • PQI 17. Overall survival: Proportion of people with pancreatic cancer who survived at 1, 2, and 5 years from diagnosis.
Quality Performance Indicator Descriptions

The QPI descriptions report outlines the detailed evidence-based descriptions for each indicator including the numerator and denominator. This report should be read in conjunction with the monitoring reports. This document includes indicators that can be measured, and those we term ‘aspirational’. These are important for clinical care quality improvement but there is currently no data available to measure and report on them.

Quality Performance Technical Specifications

The QPI technical specifications report outlines method for calculating each QPI that is reported in the associated monitoring report. This method provides enough detail to replicate our calculations every three years. It provides information on data sources, numerator criteria, denominator criteria, relevant data codes and descriptions and data flow diagrams. 

National Pancreatic Cancer Working Group

Role

The National Pancreatic Cancer QPI Working Group (NPCWG) was established in 2020 to lead and advise on the selection and calculation and implementation of pancreatic cancer quality performance indicators to support improvement of clinical process and patient outcomes.

Terms of reference

Membership

Chair

  • John Windsor, surgeon, Health New Zealand Te Whatu Ora – Te Toka Tumai/University of Auckland

Members

  • Adam Bartlett, surgeon, Health New Zealand Te Whatu Ora – Te Toka Tumai
  • Andrew MacCormick, surgeon, Health New Zealand Te Whatu Ora - Counties Manukau
  • Andrew Miller, pathologist, Canterbury Health Laboratories
  • Andrew Wilson, anaesthetist, Health New Zealand Te Whatu Ora – Te Toka Tumai
  • Anna Wojtacha, medical oncologist, Health New Zealand Te Whatu Ora - Nelson Marlborough
  • Chris McKee, radiologist, Health New Zealand Te Whatu Ora - Waitematā
  • Colleen Van Der Vyver, palliative medicine specialist, Health New Zealand Te Whatu Ora - MidCentral
  • David Orr, gastroenterologist and liver transplant hepatologist, Health New Zealand Te Whatu Ora – Te Toka Tumai
  • Dean Harris, medical oncologist, Health New Zealand Te Whatu Ora - Waitaha Canterbury
  • Dorothy Lombe, radiation oncologist, Health New Zealand Te Whatu Ora - MidCentral
  • Emma McMenamin, palliative medicine SMO, Health New Zealand Te Whatu Ora – Capital, Coast & Hutt Valley
  • Frank Weilert, gastroenterologist, Health New Zealand Te Whatu Ora - Waikato
  • Gabriel Lau, radiologist, Pacific Radiology
  • Grant Middleton, consumer representative
  • Helen Brown, dietitian, Nurse Maude Canterbury
  • Janet Hayward, general practitioner, Health New Zealand Te Whatu Ora - Nelson Marlborough
  • Jeremy Rossaak, surgeon, Health New Zealand Te Whatu Ora – Bay of Plenty
  • John Windsor, surgeon, Health New Zealand Te Whatu Ora – Te Toka Tumai/University of Auckland
  • Jonathan Koea, surgeon, Health New Zealand Te Whatu Ora - Waitematā
  • Kate Clarke, medical oncologist, Health New Zealand Te Whatu Ora – Capital, Coast & Hutt Valley
  • Matthew Drake, anatomical pathologist, Health New Zealand Te Whatu Ora – Waitaha Canterbury
  • Nadine Peake, cancer nurse coordinator, Health New Zealand Te Whatu Ora – Waitaha Canterbury
  • Paul Restall, histopathologist, Health New Zealand Te Whatu Ora – Te Toka Tumai
  • Petro Nel, clinical nurse specialist, Health New Zealand Te Whatu Ora – Te Matua a Māui
  • Saxon Connor, surgeon, Health New Zealand Te Whatu Ora – Waitaha Canterbury
  • Sayali Pendharkar-Orpe, lead science advisor, Ministry of Health Manatū Hauora
  • Simon Bann, surgeon, Health New Zealand Te Whatu Ora – Te Toka Tumai.