Leadership is a critical factor in the success of any major change initiative or quality improvement effort (Burns, 1978; Bodenheimer et al., 2004; National Institute of Standards and Technology, 2007). Fortunately, a number of organizations that already play a leadership role in oncology have the ability to influence quality through their certifying activities, financial support, and ability to inform consumers in the marketplace. Such organizations, working together, could constitute a critical mass of leadership creating substantial incentives for oncology providers to improve the delivery of psychosocial health care for patients with cancer and their families by supporting the development of a small, strategic set of performance measures addressing psychosocial health care and then incorporating these measures into their organizational policies and practices.
As the nation’s leader in cancer care, NCI has a number of venues through which performance measures could be used to improve psychosocial health care. NCI’s 61 designated cancer centers and comprehensive cancer centers together constitute the “centerpiece of the nation’s effort to reduce morbidity and mortality from cancer” (NCI, 2004:2) and are “characterized by strong organizational capabilities, institutional commitment, and trans-disciplinary, cancer-focused science; experienced scientific and administrative leadership, and state-of-the-art cancer research and patient care facilities [emphasis added]” (NCI, undated-a). NCI could encourage these facilities to set the benchmark for performance in meeting standards for psychosocial health care incorporated in the performance measures, and to measure and report their performance in providing such care.
NCI’s Outcomes Research Branch also coordinates and sponsors research aimed at improving cancer outcomes; reducing health disparities; and reducing the cancer burden on patients, families, and society. In doing so, it coordinates and funds research and applications designed to assess, monitor, and improve the quality of cancer care, and translates research findings into products and strategies for use by public and private policy makers who provide, pay for, regulate, and set standards for cancer care (NCI, undated-b). Incorporating the development and application of performance measures of psychosocial health care into this agenda also could help advance the use of such measures.
Leading private-sector funders of cancer research and demonstrations, such as the American Cancer Society, Lance Armstrong Foundation, and Susan G. Komen for the Cure Foundation, also could incentivize the calculation and public reporting of performance measures of psychosocial health care by including questions about how organizations deliver such care in their requests for proposals, making awards based on applicants’ performance in these areas, and requiring the calculation and reporting of the