Closing the feedback loop: understanding consumer, carer and clinician perspectives on the presentation of lung cancer quality of care data – a focus group study

Unwarranted variation in lung cancer care has been described by researchers and quality improvement initiatives across Australia. Although audit and feedback interventions are widely used to address variation in healthcare, the overall net benefit of such interventions can be small, which may be because interventions are not meeting the needs of recipients. The aim of this study was to understand consumer, carer and clinician perspectives regarding the optimal way to feedback lung cancer quality of care data, including feedback content, display and delivery. Convenience and snowball recruitment were utilised, with potential participants identified through a variety of methods including an earlier research project, professional networks, and social media. Focus groups were conducted between November and December 2024. Discussions were audio recorded and evaluated using a framework analysis. 39 individuals participated in a virtual or in-person focus group, including 21 consumers/carers and 18 clinicians. Both consumer/carer and clinician participant groups advocated for the measurement of timeliness indicators, despite viewing established timeliness as ‘aspirational’. They valued the evaluation of other care domains including diagnostic testing, treatment, and multidisciplinary team meeting review, in order to gain a comprehensive understanding of the quality of care. The potential for audit and feedback interventions to highlight inequities in health systems and in cancer care was raised, with organisational audit including case volume, infrastructure, and staffing viewed as useful to contextualise findings. Participants raised the critical importance of ensuring data are accurate, and that feedback is actionable and engaging. Finally, the hypothetical positive impact of public reporting was acknowledged, as were possible concerns. Participants recommended that feedback regarding lung cancer quality of care utilises comprehensive, customised and interactive approaches to maximise engagement across clinician and consumer audiences.