Identifying Coordination and Continuity of Care Indicators for Population-Based Cancer Screening Programs: A Delphi Study

Nurs Res. Sep/Oct 2018;67(5):411-418. doi: 10.1097/NNR.0000000000000300.


Background: Continuity of care and care coordination are critical issues in virtually all healthcare systems. European guidelines for the quality of screening programs for breast and colorectal cancer describe process, structure, and outcome indicators, but none specifically evaluate coordination and continuity of care during the cancer screening process.

Objective: The aim of this study was to identify indicators reflecting care coordination and continuity in population-based breast and colorectal cancer screening program.

Methods: A two-round Delphi study was conducted in a sample of 30 cancer screening nurses to identify quality indicators.

Results: The final Delphi consensus resulted in six core indicators for the cancer screening program: adequacy of the referral of the target population from the screening program to other health services, waiting time for referral to other health services, understanding of the screening program by professionals involved in the process, effective information flow between professionals involved in the process, participants' perception of the screening program, and, finally, participants' understanding of information about the program.

Conclusion: The evaluation of indicators is crucial for quality improvement and should allow a measuring system to be established that would allow a comparison of outcomes for all population-based cancer screening programs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Neoplasms / diagnosis*
  • Colorectal Neoplasms / diagnosis*
  • Continuity of Patient Care*
  • Delphi Technique
  • Early Detection of Cancer*
  • Female
  • Humans
  • Male
  • Quality Improvement
  • Quality Indicators, Health Care*