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Quality Dimensions

The Cancer System Quality Index reports by disease site and quality dimension. The focus on quality is crucial for the continuous drive towards better cancer care in Ontario.

This year, 6 quality dimensions characterize the aspects of the system that make up high-performing cancer care for patients: Effective, Efficient, Equitable, Timely, Safe and Person-Centred. These quality dimensions align with the 6 system goals of the Ontario Cancer Plan and the quality domains from the National Academy of Medicine.

There are several domains and disease sites for which indicators are still under development; future editions of the Cancer System Quality Index will provide a more comprehensive view of performance along the quality domains and will include additional indicators representative of a high performing cancer system. See Indicators Under Development for more information.

The following quality indicators selected for 2019 provide a snapshot of the performance of the cancer system along each quality domain.


Definition: Providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).

Why it is important: The cancer system in Ontario aims to provide effective cancer care based on best evidence. Effective cancer care means that patients receive evidence-based care that facilitates the best possible outcome for their health.

Indicators in the present reporting cycle:


Definition: Avoiding waste, including waste of equipment, supplies, ideas and energy.

Why it is important: Ontarians want healthcare resources to be used optimally, with minimal duplication and waste. To continue providing high quality cancer services into the future, it is important for our cancer system to be sustainable so that demand for care is met.

Indicators in the present reporting cycle:


Definition: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location and socioeconomic status.

Why it is important: Everyone in Ontario should be their healthiest. Better health equity across the cancer system helps ensure that people are not disadvantaged by who they are, where they live or what resources they have.

Indicators in the present reporting cycle:


Definition: Reducing waits and sometimes harmful delays for both those who receive and those who give care.

Why it is important: Many patients say that waiting for care is one of the most stressful parts of having or suspecting cancer. Reduced wait times are important for quality of life and decision-making, and can be important for clinical outcomes.

Indicators: Indicators that relate to this quality dimension are under development, and will be reported in future years. 


Definition: Avoiding harm to patients from the care that is intended to help them.

Why it is important: Patients, caregivers and healthcare professionals expect their health system to deliver safe care. There is a need to be proactive in reducing avoidable harm in all care settings.

Indicator in the present reporting cycle:


Definition: Providing care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring patient values guide all clinical decisions.

Why it is important: The patient’s view of the care experience is an important factor that defines excellence of care. The delivery of responsive and respectful person-centred care is important for optimizing quality of life across the cancer care continuum.

Indicators in the present reporting cycle: