Table 3.

Examples of effects of the external peer review programs as mentioned by interviewees (N = 31) grouped per theme

Theme	Examples of impact given by the interviewees
Position of cancer care in hospital Oncology committee	Cancer care became a priority (N = 9) Large committees were formed with representatives from all disciplines treating cancer patients (N = 9) role of committee was officially established in hospital organization (N = 2) Committee got responsibility for policy making (N = 5) Functioning of committee improved (N = 3) Structural meetings were organized with board of directors and medical staff (N = 2)
Cooperation	Involvement of “smaller” disciplines such as gynecologists and urologists (N = 6) Improved communication between specialists and between specialists and nursing staff (N = 4) Improved communication with general practitioners (N = 1)
Multidisciplinary patient care meetings	Involvement smaller disciplines in the meetings (N = 3) Protocols on which patients have to be discussed (N = 14) Uniformity of reporting (N = 1)
Structure	Increased number of nursing staff (N = 6) Investments in ICT (N = 1)
Delivery of care	Advice on the introduction of integrated care pathways (N = 2) Concentration of chemotherapy administration within the hospital (N = 1)
Referral policies	Referral policies were made for rare tumors (N = 1) Official agreements were signed with other hospitals on which patients to treat and which to refer for further treatment. (N = 3)
Nursing staff	Introduction of specialized oncology nurses (N = 6) Education (N = 2)
Psychosocial care	Increased number of psychosocial staff (N = 6) Clarity on the role and positioning of psychosocial staff (N = 1) Introduction psychosocial protocols (N = 1)
Readiness for change	Organization is better prepared to adapt to future changes (N = 4)