[Accelerated diagnosis and treatment initiation for head and neck cancer patients].
BACKGROUND
Acceleration of diagnosis and initiation of treatment for head and neck cancer requires optimal organisation and multidisciplinary collaboration. A project at the Head and Neck Oncology Centre, Aarhus University Hospital aimed at accelerating patient flow.


METHODS
The initiatives were implemented throughout 2007. Focus was on optimizing logistics for all patients referred to the centre with suspected head and neck cancer. Initiatives included a full-time coordinator, pre-booked slots for clinical work-up and weekly tumour boards. Key dates were registered and relevant intervals were quantitatively evaluated and compared to a reference group from 2006.


RESULTS
We registered 446 patients. Waiting times for first clinical examination at the ENT department were reduced from medially eight to two days through 2007 (p < 0.0001). Time from first clinical examination to referral for treatment was reduced from medially 21 to nine days (p < 0.0001). Time from referral to treatment to initiation of treatment was reduced from medially 26 to 15 days (p < 0,001). The net result of these reductions was a reduced overall median time (from primary referral to initiation of treatment) from medially 57 days by end of 2006 to medially 29 days by end of 2007 (p < 0,0001).


CONCLUSIONS
Logistic changes and especially introduction of a full-time coordinator, a multidisciplinary tumour board and a generally higher priority for head and neck cancer patients resulted in a significant acceleration regarding diagnosis and start of treatment from 2006 to 2007.
Toustrup
Kasper
K
Afdelingen for Eksperimentel Klinisk Onkologi, Arhus Sygehus, Nørrebrogade 44, bygn. 9, DK-8000 Arhus C, Denmark. kasper@oncology.dk
Lambertsen
Karin
K
Ulhøi
Benedicte Parm
BP
Sørensen
Leif
L
Sørensen
Hanne Birke
HB
Grau
Cai
C
D003266:Continuity of Patient Care / Q000458:organization & administration; D019091:Critical Pathways; D004434:Early Ambulation; D055088:Early Detection of Cancer; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D006801:Humans; D033183:Interdisciplinary Communication; D007902:Length of Stay; D013997:Time Factors; D014850:Waiting Lists