Annelotte van Bommel

20 national guidelines, defining quality indicators and standards of care, and by organizing post-graduate symposia. IKNL is a quality institution for oncological and oncological palliative care, which hosts the Netherlands Cancer Registry (NCR), in which data of all newly diagnosed malignancies in the Netherlands are registered since 1989. Information regarding treatment and outcomes of breast cancer is extracted from the medical records by specially trained data-managers in each hospital in the Netherlands. Moreover, IKNL is the NABON and NBCA secretary. DICA was founded in 2011 with the objective to facilitate the start-up of new nation-wide clinical audits, following the successful initiation of the Dutch Surgical Colorectal Audit (DSCA) in 2009. 5 In 2009, the NABON established a scientific committee to initiate the NBCA. The scientific committee consisted of mandated members of all medical associations involved in breast cancer care in order to constitute a national clinical audit: the Dutch Radiological Society (NVvR), the Dutch Society for Pathology (NVvP), the Association of Surgeons of the Netherlands (NVvH), the Netherlands Society for Plastic Surgery (NVPC), the Dutch Society of Radiotherapy and Oncology (NVRO) and the Dutch Society of Medical Oncology (NVMO). The Breast Cancer Patients Association (BVN) participated to represent the patients’ voice. Later, a representative of the Dutch health care insurance companies (ZN) joined the scientific committee and in 2015 a mandated member of the Dutch Society for Clinical Genetics (VKGN) joined the working group. The primary goal of the NBCA is the nation-wide monitoring of quality of care and the provision of feedback to the participating individual hospitals on their outcomes in relation to “real-time” national benchmark information as a first step to improve the quality of breast cancer care in the Netherlands by enabling institutions to evaluate their data and start improvement projects. The aforementioned scientific committee is responsible for the draft and development of a multidisciplinary set of indicators used to express and monitor the various qualitative aspects of care. Other tasks include in-depth outcomes research and preparation of annual reports for public use to improve transparency.