Prostate Cancer Performance Indicators

There are around 4,000 new prostate cancer cases and 700 deaths a year, making it one of the leading causes of cancer death in Aotearoa. It remains the most common cancer to affect men nationwide, regardless of ethnicity, and results in significant morbidity.

Te Aho o Te Kahu worked with the National Urological Cancer Working Group (UCWG) to develop a set of proposed QPIs for prostate cancer.

Te Aho o Te Kahu and the UCWG worked together to develop a set of QPIs for prostate cancer. The first Prostate Cancer Quality Improvement Monitoring Report, using 2016-2018 data was published in early 2021.

Quality Improvement Monitoring Report

The Prostate Cancer Quality Improvement Report was published in 2021, including data from years 2016 to 2018. This report presents data for five QPIs.

Te Aho o Te Kahu expects districts (previously District Health Boards prior to 1 July Health and Disability Reforms) will review their performance and, where unwarranted variation is identified, take action to improve their performance and patient outcomes. The differences noted in our findings and discussed in this report will also help guide national quality improvement programmes.

The reported QPIs in the Prostate Cancer Quality Improvement Monitoring Report 2021:

Route to diagnosis: Proportion of men with prostate cancer who are diagnosed following presentation to an emergency department
Discussion with radiation oncologist before radical prostatectomy: Proportion of men with prostate cancer being considered for radical prostatectomy who see a radiation oncologist before treatment, including remote consultations
Medical oncology review of patients with advanced disease: Proportion of men with advanced prostate cancer who see a medical oncologist
Length of stay after surgery:
- (i) Proportion of men with prostate cancer discharged more than two days after radical prostatectomy
- (ii) Proportion of men with prostate cancer discharged five or more days after radical prostatectomy
Equitable access to treatment: Proportion of men treated with radical surgery, curative radiation treatment and either radical surgery or curative radiation treatment.

Reports:

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.

Improvement Plan (Action Plan)

This action plan should be read in conjunction with the monitoring report. Districts can review the monitoring report to identify where their performance is significantly different to that of other districts. This can then lead to quality improvement principles to plan for and implement improvement projects in those areas.

The ‘recommended actions’ set out in this plan are intended as a guide to the types of actions districts could take to improve their performance. Districts can develop and implement local quality improvement plans with actions appropriate to their local context and priorities.

We note that some districts are already undertaking quality improvement work. The recommendations in this action plan do not prevent additional actions or the districts and hospitals continuing to follow existing effective quality improvement activities.

National Urological Cancer Working Group

Chair

Andrew Williams, urologist, Health New Zealand Te Whatu Ora - Te Toka Tumai Auckland

Deputy Chair

Suzanne Beuker, urologist, Health New Zealand Te Whatu Ora - Nelson Marlborough

Members

Emma Drake, cancer nurse specialist, Health New Zealand Te Whatu Ora – Southern

Peter Fong, medical oncologist, Health New Zealand Te Whatu Ora - Te Toka Tumai Auckland

Jason Gurney, associate professor and director, Cancer and Chronic Conditions Research Group, University of Otago

Tui Hancock, whānau ora nurse practitioner, Central Primary Health Organisation

Sharon Harber, cancer nurse specialist, Health New Zealand Te Whatu Ora - South Canterbury

Quinten King, urologist, Te Whatu Ora - MidCentral

Madhu Koya, consultant urologist, Health New Zealand Te Whatu Ora ‐Waitematā

Remy Lim, consultant radiologist, Health New Zealand Te Whatu Ora - Te Toka Tumai Auckland

Rob Macfarlane, consumer representative

Stephen Mark, urologist, Health New Zealand Te Whatu Ora ‐ Waitaha Canterbury

John Matthews, consultant radiation oncologist, Health New Zealand Te Whatu Ora - Te Toka Tumai Auckland

Sarah Mortimer, operations manager, blood, cancer, renal & palliative care, Health New Zealand Te Whatu Ora - Capital, Coast and Hutt Valley

Tiffany Schwass, cancer nurse specialist, Health New Zealand Te Whatu Ora - Waikato

Alvin Tan, medical oncologist, Health New Zealand Te Whatu Ora - Waikato

Simon van Rij, urologist, Health New Zealand Te Whatu Ora - Te Toka Tumai Auckland

Jonathan Zwi, pathologist, Health New Zealand Te Whatu Ora - Te Toka Tumai Auckland

Cancer Care Data Explorer

The Cancer Care Data Explorer (the explorer) is a tool for service providers and clinicians to explore their QPI results by region and district (previously District Health Boards prior to 1 July 2022 Health and Disability Reforms), gender, age group, ethnic group, and neighbourhood deprivation.

The results are presented from the published quality improvement monitoring reports in an interactive dashboard. The dashboard will be updated with further cancer types as each monitoring report is published.

View the Cancer Care Data Explorer.

Route to cancer diagnosis dashboard

This interactive tool allows you to explore data on cancers diagnosed within 30-days of emergency or acute (unplanned) hospital admission. Patients who are diagnosed following an emergency or unplanned hospital admission often present with severe symptoms, indicating an advanced stage of cancer resulting in poorer outcomes. This tool presents the latest indicator results for 22 cancer types by geographic areas and by age, sex, ethnic group, rural-urban status and neighbourhood deprivation.

View the Route to cancer diagnosis dashboard.