Table 1.

Process-Related Quality Metrics

Quality Metric	Eligibility	Approved by AHNSa	Recommended by NCCN (February 2014)a
Pretreatment evaluation
Time from referral to clinic visit ≤14 d	All patients
Examination of pharynx and larynx (IME, FFL, DL) before definitive operation	All patients		Yesb
cTNM stage documented	All patients	Yes
Tobacco cessation counseling	Tobacco use within past 6 mo	Yes	Yesb
Dental evaluation prior to treatment	Teeth and clinical AJCC stage III or IV disease		Yesb
Internal review of pathologic findings	Pathologic findings from outside hospital
Tumor board presentation	All patients
Treatment related
Time from initial evaluation to surgery ≤21 d	All patients
Elective neck dissection with ≥18 lymph nodes	Undergoing elective neck dissection
pTNM stage documented	All patients
Margin status documented	All patients
No unplanned surgery ≤14 d	All patients
No unplanned readmission ≤30 d after discharge	All patients
Referral for adjuvant radiotherapy if stage III or IV	Pathologic AJCC stage III or IV tumors	Yes	Yes
Referral for adjuvant chemoradiotherapy if ECS or positive margins	Positive margins or ECS	Yes	Yes
Start of adjuvant therapy ≤6 weeks postoperatively	Receiving adjuvant therapy		Yes
Posttreatment surveillance
Thyroid function testing ≤12 mo after radiotherapy	Received adjuvant therapy and alive 12 mo after its completion	Yes	Yes
Surveillance imaging ≤6 mo after therapy completion	No clinical suspicion of recurrence and alive 6 mo after completion		Yes
Multidisciplinary follow-up	Received multimodality therapy

Abbreviations: AHNS, American Head and Neck Society; AJCC, American Joint Committee on Cancer; cTNM, clinical tumor, node, metastasis; DL, direct laryngoscopy; ECS, extracapsular spread; FFL, flexible fiberoptic laryngoscopy; IME, indirect mirror examination; NCCN, National Comprehensive Cancer Network; pTNM, pathologic tumor, node, metastasis.

^aEmpty cells indicate institutional metric with face validity.

^bRecommended by NCCN when indicated.