11. Care structures for actinic keratosis and squamous cell carcinoma – Actinic keratosis and squamous cell carcinoma of the skin

C. Garbe, U. Leiter

Skin tumor centers have been established in Germany since early 2009, the first of which was in Heidelberg; 63 centers were certified by the end of 2018. Certification takes place in 2 phases:

• Review of the survey form skin tumor centers (downloadable at www.onkozert.de) by two expert auditors, return with information about deviations or suggestions for improvement (evaluation of the survey form) to the center.
• Specialist audit conducted by the 2 specialist auditors who also evaluated the survey questionnaire. Not only the center itself but also the cooperating departments are visited.

The heart of the skin tumor center is the interdisciplinary skin tumor conference. This is where as many therapeutic decisions as possible should be made. The establishment of a dedicated skin tumor conference/skin tumor board with the main participants from dermatology, internal oncology, surgery, radiology, and radiotherapy is an essential step for the establishment of the center. Written agreements with main treatment partners and additional treatment partners must be established. Minimum numbers in the treatment of skin tumor patients are required.

Another important point is tumor documentation. All skin tumors must be recorded and documented electronically. Patient pathways and SOPs (Standard Operating Procedures) for treatments (sentinel lymph node, chemotherapy, etc.) are presented. Good cooperation with referring physicians, with psycho-oncology and with social services must be ensured.

The aim is to coordinate the care and interdisciplinary treatment of skin tumor patients, especially with locally advanced or metastatic tumors, according to the current state of medical knowledge.

The implementation of the present S3 guideline plays an essential role in all care structures.

 

S. Wesselmann, H. Adam

Quality indicators (QIs) are measures whose collection serves to assess the quality of the underlying structures, processes, or outcomes [564][565]. QI are an important instrument of quality management. The aim of their use is the continuous improvement of care by presenting the results of care, critically reflecting on them and improving them if necessary. The present selection of QIs was prepared according to the methodology of the German Guideline Program in Oncology. For the derivation process, a "Quality Indicators Working Group" was constituted. This group created the final set of QIs based on the strong recommendations of the guideline (recommendation strength A, "shall“) and the results of the search for existing national and international QIs. The exact procedure and composition of the WG are outlined in the guideline report.

After a face-to-face meeting and a telephone conference of this WG, 1 QI was included in the final indicator set.