title: Reducing the Time From Diagnosis to Treatment of Patients With Stage II/III Rectal Cancer at a Large Public Hospital.
abstract: Curative-intent therapy for stage II/III rectal cancer is necessarily complex. Current guidelines by the National Comprehensive Cancer Network recommend preoperative concurrent chemoradiation followed by resection and additional adjuvant chemotherapy. We used standard quality improvement methodology to implement a cost-effective intervention that reduced the time from diagnosis to treatment of patients with stage II/III rectal cancer by approximately 30% in a large public hospital in Houston, Texas. Implementation of the program resulted in a reduction in time from pathologic diagnosis to treatment of 29% overall, from 62 to 44 days. These gains were cost neutral and resulted from improvements in scheduling and coordination of care alone. Our results suggest that: (1) quality improvement methodology can be successfully applied to multidisciplinary cancer care, (2) effective interventions can be cost neutral, and (3) effective strategies can overcome complexities such as having multiple sites of care, high staff turnover, and resource limitations.
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX mhoffmann@kumc.edu.
authors: Marc S
authors: MS
authors: Hoffmann
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Lori A
authors: LA
authors: Leslie
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Ryan W
authors: RW
authors: Jacobs
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Stefanos
authors: S
authors: Millas
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Venkateswar
authors: V
authors: Surabhi
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Henry
authors: H
authors: Mok
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Pavan
authors: P
authors: Jhaveri
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Marylee M
authors: MM
authors: Kott
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Lymesia
authors: L
authors: Jackson
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Alyssa
authors: A
authors: Rieber
authors: University of Kansas Cancer Center, Overland Park, KS; John Theurer Cancer Center, Hackensack; Levine Cancer Center, Charlotte, NJ; The University of Texas at Houston; Baylor College of Medicine; Harris Health System; and The University of Texas MD Anderson Cancer Center, Houston, TX.
authors: Nishin A
authors: NA
authors: Bhadkamkar
mesh_terms: D019468:Disease Management; D006779:Hospitals, Public; D006801:Humans; D009367:Neoplasm Staging; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D013781:Texas; D013997:Time Factors; D061665:Time-to-Treatment