Development targets in the clinical quality registries for cancer and non-cancer diseases

The Danish clinical quality registries contribute to clinical quality improvement by utilizing quality indicators and development targets. This study examines fulfillment of development targets across all registries for cancer and non-cancer diseases at national, regional, and hospital levels. Annual summarized data from Danish clinical quality registries (2019-2023) were accessed. The proportion of fulfilled development targets was presented overall and in strata according to registries covering cancer or non-cancer diseases, indicators describing processes or results, and established or supplemental indicators. Regional differences and changes over time were evaluated. The data evaluated 13,305,861 patient pathways and 697 indicators from 65 registries. Overall, 57% of hospital-level development targets were fulfilled (median 58%, IQR:44–76%). The 24 cancer registries fulfilled 63% of targets (median:60% IQR:49-76%), while the 41 non-cancer registries fulfilled 54% (median:54%, IQR:38-75%). Fulfillment was higher for result indicators (68%) than process indicators (44%), and for established (56%) than supplemental indicators (44%). Regional fulfillment ranged from 50% (Region Zealand) to 64% (the Central Denmark Region). Target fulfillment increased by five percentagepoints during the study period. The Danish clinical quality registers varied in the approach to defining development targets, ranging from very conservative to very ambitious. The development targets were more ambitious for registries of non-cancer diseases than cancer diseases, more ambitious for process- than for result indicators, and more ambitious for supplemental compared to established indicators. Setting clinical quality improvement targets requires balancing ambition with realism. The ambitious target setting for supplemental (often new) indicators and process indicators is expected, as these have a high potential for further improvement. The data suggest that the Danish clinical quality registries in cancer diseases could benefit from raising some of the development targets. • Quality indicators and targets guide quality improvement in Danish healthcare • We analyzed >13 million patient pathways and 697 indicators in 65 Danish registries • Overall, 57% of targets were met (63% in cancer- vs. 54% in non-cancer registries) • The development targets ranged from conservative to ambitious across the registries • Overall, Target fulfillment improved by 5 percentage points from 2019 to 2023