Clear evidence is available regarding the wide variation in the quality of cancer care delivered in the United States. These findings led the Institute of Medicine (IOM) in 1999 to call for major changes in cancer care delivery to improve quality and enhance the patient experience. Key domains for the recommendations included steps to define appropriate quality care, identify appropriate measures of care, establish mechanisms to collect and analyze cancer treatment information, and assure that care addresses overall needs of patients beyond the core processes of treatment. Despite major changes in medicine, and with the continued and rapid increase in the cost of cancer care, the IOM reiterated their findings in 2013, stating that there exists a crisis in quality, appropriateness, and access to cancer care.

The articles in this supplement provide insights into the collective wisdom at the participating NCCN centers regarding the best target areas for improving care and the patient experience. These efforts may help other programs define targets for practice evaluation and continuous quality improvement. These key efforts are necessary to improve cancer outcomes and experiences, and will be necessary in the coming era of public quality reporting and value-based reimbursement.