Developing clinical indicators for oncology: the inaugural cancer care indicator set for the Australian Council on Healthcare Standards

Eva Segelov, Christine Carrington, Sanchia Aranda, David Currow, John R Zalcberg, Alexander G Heriot, Linda Mileshkin, John Coutsouvelis, Jeremy L Millar, Brian T Collopy, Jon D Emery, Phoebe Zhang, Simon Cooper, Carmel O’Kane, Janet Wale, Stephen J Hancock, Anthony Sulkowski and John Bashford
Med J Aust 2021; 214 (11): . || doi: 10.5694/mja2.51087
Published online: 31 May 2021


Introduction: The Australian Council on Healthcare Standards (ACHS) sponsored an expert‐led, consensus‐driven, four‐stage process, based on a modified Delphi methodology, to determine a set of clinical indicators as quality measures of cancer service provision in Australia. This was done in response to requests from institutional health care providers seeking accreditation, which were additional and complementary to the existing radiation oncology set. The steering group members comprised multidisciplinary key opinion leaders and a consumer representative. Five additional participants constituted the stakeholder group, who deliberated on the final indicator set.

Methods and recommendations: An initial meeting of the steering group scoped the high level nature of the desired set. In stage 2, 65 candidate indicators were identified by a literature review and a search of international metrics. These were ranked by survey, based on ease of data accessibility and collectability and clinical relevance. The top 27 candidates were debated by the stakeholder group and culled to a final set of 16 indicators. A user manual was created with indicators mapped to clinical codes. The indicator set was ratified by the Clinical Oncology Society of Australia and is now available for use by health care organisations participating in the ACHS Clinical Indicator Program.

This inaugural cancer clinical indicator set covers high level assessment of various critical processes in cancer service provision in Australia. Regular reviews and updates will ensure usability.

Changes in management as a result of this statement: This is the inaugural indicator set for cancer care for use across Australia and internationally under the ACHS Clinical Indicator Program. Multidisciplinary involvement through a modified Delphi process selected indicators representing both generic and specific aspects of care across the cancer journey pathway and will provide a functional tool to compare health care delivery across multiple settings. It is anticipated that this will drive continual improvement in cancer care provision.

  • Eva Segelov1,2
  • Christine Carrington3
  • Sanchia Aranda4
  • David Currow5
  • John R Zalcberg6
  • Alexander G Heriot7,8
  • Linda Mileshkin8
  • John Coutsouvelis1,9
  • Jeremy L Millar1,9
  • Brian T Collopy10,11
  • Jon D Emery12
  • Phoebe Zhang11
  • Simon Cooper11
  • Carmel O’Kane13
  • Janet Wale11
  • Stephen J Hancock14
  • Anthony Sulkowski15
  • John Bashford16

  • 1 Monash University, Melbourne, VIC
  • 2 Monash Health, Melbourne, VIC
  • 3 Princess Alexandra Hospital, Brisbane, QLD
  • 4 Cancer Council Australia, Sydney, NSW
  • 5 Cancer Institute NSW, Sydney, NSW
  • 6 Alfred Centre, Melbourne, VIC
  • 7 Epworth HealthCare, Melbourne, VIC
  • 8 Peter MacCallum Cancer Centre, Melbourne, VIC
  • 9 Alfred Health, Melbourne, VIC
  • 10 CQM Consultants, Melbourne, VIC
  • 11 Australian Council on Healthcare Standards, Sydney, NSW
  • 12 University of Melbourne, Melbourne, VIC
  • 13 Wimmera Cancer Centre, Wimmera Health Care Group, Horsham, VIC
  • 14 University of Newcastle, Newcastle, NSW
  • 15 Western Private Hospital, Melbourne, VIC
  • 16 Icon Group, Brisbane, QLD



The Australian Council on Healthcare Standards provided project management and funding for travel logistics to attend the face‐to‐face meetings.

Competing interests:

No relevant disclosures.


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