Reduction in waiting time for diagnosis and treatment of head and neck cancer - a fast track study.
Acceleration of diagnosis and initiation of treatment for head and neck cancer requires optimal organization and multidisciplinary collaboration. A project at the Head and Neck Oncology Centre, Aarhus University Hospital aimed at accelerating patient flow.


METHODS
Initiatives were implemented throughout the year 2007. Focus was on optimizing logistics for all patients referred to the center with suspected head and neck cancer. Initiatives included a full-time case manager, pre-booked slots for clinical work-up and weekly tumor-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 on ENT department were reduced from median eight to median two days through 2007 (p < 0.0001). Time from first clinical examination and until referral for treatment was reduced from median 21 to median nine days (p < 0.0001). Time from referral to treatment and until initiation of treatment was reduced from median 26 to median 15 days (p < 0.001). The net result of these reductions was a reduced overall time from median 57 days ultimo 2006 to median 29 days ultimo 2007 (p < 0.0001).


CONCLUSIONS
The current project has shown that it is possible to reduce waiting times in head and neck cancer. Through logistic changes, employment of a full-time case manager, strengthening the multidisciplinary tumor board and giving higher priority for head and neck cancer patients, the overall time from first suspicion of cancer until treatment start was reduced from 57 calendar days to 29 calendar days.
Department of Oto-Rhino-Laryngology, Aarhus University Hospital, Denmark. kasper@oncology.dk
Kasper
K
Toustrup
Karin
K
Lambertsen
Hanne
H
Birke-Sørensen
Benedicte
B
Ulhøi
Leif
L
Sørensen
Cai
C
Grau
D000054:Acceleration; D000465:Algorithms; D002277:Carcinoma / Q000175:diagnosis* / Q000628:therapy*; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D012042:Registries; D013997:Time Factors; D017748:Time Management / Q000458:organization & administration; D014850:Waiting Lists