Abstract C68: Towards more equitable quality of breast cancer care: The role of the Chicago Breast Cancer Quality Consortium and expansion throughout the state of Illinois
Authors: Irizarry Bethliz , Rauscher Garth H. , Murphy Anne-Marie 
Published: March 2017

Background: The Metropolitan Chicago Breast Cancer Task Force (MCBCTF) began its mission of eliminating Black/White breast cancer disparities in 2007. At the time, Black women in Chicago were 62% more likely to die from breast cancer than their White counterparts; which at the time represented one of the highest breast cancer mortality disparities of any urban area in the nation. Here we describe the current status of this quality improvement program, its successful expansion statewide, the variety of data collection and feedback approaches being undertaken, and some preliminary results.

Methods: The MCBCTF created the Chicago Breast Cancer Quality Consortium (consortium) in response to 2007 report of stakeholders that called for such a QI program. The consortium is the first patient safety organization in the nation that addresses breast cancer care. Initially, the consortium collected aggregate counts on screened patients across approximately 50 facilities in metropolitan Chicago. A set of 11 quality benchmarks were based on data from the Breast Cancer Surveillance Consortium. Aggregate counts were used to calculate 11 corresponding measures including those pertaining to recall rate, timely follow up care, and cancer detection. In 2013 the initiative went statewide and was tied to supplemental reimbursement for screening mammography of Medicaid patients to equal that of Medicare. The statewide initiative includes the following data collection initiatives: benchmarks measures described earlier; a mammography facility survey; a survey of radiologists at these facilities; facility counts of the number of screened patients by zip code of residence, an estimate of patient mix regarding recent prior screening (how well screened a facility's patient population is impacts ability to meet benchmarks). Future initiatives will include obtaining an estimate of patient mix with respect to race/ethnicity and age (age affects risk which in turn impacts benchmarks). Data are analyzed and reported back to the facility. Metrics are reviewed and revised after each collection cycle.

Results: Data submitted in 2016 for screenings conducted in calendar year 2013 represented over 700,000 screening mammograms performed in Illinois at 174 facilities, representing nearly 80% of Medicaid volume and a 54% increase in facility participation from 2015. In addition, 354 radiologists completed the radiologist survey, providing input on their attitudes regarding audits, and other aspects of performance. Of the 174 participating facilities, 168 facilities submitted patient residential zip codes, allowing the MCBCTF to map where the women each facility serves live.

Conclusion: By enabling facilities the opportunity to participate in activities to improve the quality of care, by helping facility staff in collecting and reporting out measures and in feeding results back to institutions, this initiative strives to create substantial change in quality of care that will translate into reductions in breast cancer mortality and mortality disparities. Additionally, understanding the landscape in which women receive care allows the MCBCTF to employ interventions to reduce disparities.

Citation Format: Bethliz Irizarry, Garth H. Rauscher, Anne-Marie Murphy. Towards more equitable quality of breast cancer care: The role of the Chicago Breast Cancer Quality Consortium and expansion throughout the state of Illinois. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C68.