The benefits of screening high-risk populations for lung cancer with LDCT outweigh the harms if screening is implemented in a strictly controlled manner.
E ffective communication between health care providers is essential to patient safety and quality of care. 1-6 A retrospective study of 14 000 admissions found that communication failures were the most common cause of preventable disability or death and were nearly twice as common as those due to inadequate medical skill. 6 A major type of communication failure is sending a page to the wrong physician. Prior studies have described paging problems such as paging the wrong physician, unanswered pages, and delayed responses but do not quantify the extent of the problem. 3 Our primary aim was to quantify the frequency of pages sent to the wrong physician in 2 academic teaching hospitals and to examine the potential clinical importance of these errors. Methods. Sunnybrook Health Sciences Centre (SHSC) and the Toronto General Hospital (TGH) are tertiary care academic teaching hospitals affiliated with the
Lung cancer is the leading cause of cancer death in Canada. The organization of health care services is central to the delivery of accessible, high-quality medical care and may be one factor that influences patient outcome. An exciting opportunity arose for clinicians to initiate the redesign of lung cancer services provided by three institutions in the Greater Toronto Area. This qualitative report describes the integrated lung cancer network that they developed, the innovation it has facilitated, and the systematic approach being taken to evaluate its impact. Available clinical resources were deployed to restructure services along patient-centred lines and to provide greater access to the specialist lung cancer team. A non-hierarchical clinical network was established that consolidates the lung cancer team. A multi-institutional and multidisciplinary tumour board and comprehensive thoracic oncology clinics are at its core. This innovative organizational paradigm considers all of the available services at each facility and aims to fully integrate specialists across the three institutions, thereby maximizing resource utilization. We believe that this paradigm may have wider applicability. The network is currently working to complete a current program of further service improvements and to objectively assess its impact on patient outcome.
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