Critical path analysis in head and neck cancer: a management technique for surgical oncology

Wheelwright, Roger; Birchall, MA; Boaden, Ruth; Pearce, Gregory L.; Lennon, Anne Marie

doi:10.1054/ejon.2002.0196

Cited by 5 publications

(14 citation statements)

References 10 publications

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“…Time from first contact to treatment slightly increased in two studies, 49,52 reduced by 3% in a third study, 48 and decreased in the fourth study 45 across three different initial treatment modalities, with the decrease more apparent for patients initially treated with chemotherapy or radiotherapy. The diagnostic interval remained the same in two studies 47,49 after implementation of benchmarking and standards, and increased by 5 days after implementation of an Oral Cancer Care Guide 44 .…”

Section: Resultsmentioning

confidence: 89%

“…Incorporation of associate providers decreased the “third‐available” time from 56 to 27 days, 51 and implementation of a “Low‐Resource Tool” for patient tracking increased the proportion of patients with a treatment package time <100 days to 95% (pre‐intervention value not stated) 46 . Time from first outpatient appointment to joint head and neck clinic increased slightly after implementing benchmarking and standards in one study, 49 but decreased by 10% in a second study using critical pathway analysis 48 . Implementation of an integrated care program showed a 3% increase in the proportion of patients seen by a consultant within 1 day of referral and a large increase in the proportion of patients commencing treatment within 30 days of first consultation 45 .…”

Section: Resultsmentioning

confidence: 99%

“…One study 51 assessed introduction of associate providers (physician assistants and nurse practitioners) to a head and neck clinic, and another study 46 evaluated a “Low‐Resource Tool” to prospectively track patients from referral to treatment. Studies conducted in England evaluated implementation of benchmarking and standards suggested in the Calman–Hine report, 49 implementation of an Oral Cancer Care Guide in two Local Dental Networks, 44 and critical pathway analysis and an extra head and neck clinic at a single site 48 . The remaining studies evaluated an integrated care program, 45 system re‐design to enable fast access to diagnosis, 47 and work‐flow re‐design over two phases 41 …”

Section: Resultsmentioning

confidence: 99%

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Interventions to reduce times to diagnosis and treatment of head and neck cancer: A systematic review and narrative synthesis

et al. 2023

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Background We systematically reviewed evidence of health system interventions to reduce diagnostic and treatment intervals for people with head and neck cancer (HNC). Methods Electronic databases were searched from inception to 30 April 2020 for controlled or uncontrolled comparative studies. Primary outcome was any time interval between first clinical presentation and treatment onset. Results Thirty‐seven studies were included. Four types of interventions were identified: single clinic‐based (N = 4), multidisciplinary clinic‐based (N = 15), hospital or service re‐design (N = 12), and health system re‐design (N = 6). There was some evidence that multidisciplinary interventions improve timeliness of diagnosis and treatment; however, evidence of long‐term effectiveness was lacking. Study quality was assessed as either low or moderate. Conclusions Interventions to reduce times to diagnosis and treatment of HNC are heterogeneous, with limited evidence of effectiveness. Future interventions should account for the complex and dynamic nature of health systems and adhere to best‐practice principles for early‐diagnosis research.

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Section: Resultsmentioning

confidence: 89%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Interventions to reduce times to diagnosis and treatment of head and neck cancer: A systematic review and narrative synthesis

et al. 2023

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“…However, only two networks showed signs of having centralised in this way, and, probably as a result, the number of patients treated per clinician remained as tiny as in a 1997 study (Edwards et al, 1997). The use of care/critical pathway techniques (Wheelwright et al, 2002) might help identify where the rate-limiting steps are occurring in each Trust. Alternatively, the provision of more facilities by the recent cash injection into cancer services may have shortened times post-2000 (Department of Health, 2002).…”

Section: Process Timesmentioning

confidence: 97%

Effect of process standards on survival of patients with head and neck cancer in the south and west of England

Birchall

Bailey²,

King³

2004

Br J Cancer

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“…Management protocols and clinical pathways have helped to streamline the clinical work-up, treatment, and follow-up. [5112548] Although these tools have helped standardize the more routine aspects of this patient population care, they certainly do not preclude personalized care. In addition, healthcare providers participating in multidisciplinary teams also recognize benefits including confidence and satisfaction in rendered care and increased job satisfaction.…”

Section: Advantages Of Multidisciplinary Teamsmentioning

confidence: 99%

Teamwork in skull base surgery: An avenue for improvement in patient care

McLaughlin¹,

Carrau²,

Kelly³

et al. 2013

Surg Neurol Int

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Background:During the past several decades, numerous centers have acquired significant expertise in the treatment of skull base pathologies. Favorable outcomes are not only due to meticulous surgical planning and execution, but they are also related to the collaborative efforts of multiple disciplines. We review the impact of teamwork on patient care, elaborate on the key processes for successful teamwork, and discuss its challenges.Methods:Pubmed and Medline databases were searched for publications from 1970 to 2012 using the following keywords: “teamwork”, “multidisciplinary”, “interdisciplinary”, “surgery”, “skull base”, “neurosurgery”, “tumor”, and “outcome”.Results:Current literature testifies to the complexity of establishing and maintaining teamwork. To date, few reports on the impact of teamwork in the management of skull base pathologies have been published. This lack of literature is somewhat surprising given that most patients with skull base pathology receive care from multiple specialists. Common factors for success include a cohesive and well-integrated team structure with well-defined procedural organization. Although a multidisciplinary work force has clear advantages for improving today's quality of care and propelling research efforts for tomorrow's cure, teamwork is not intuitive and requires training, guidance, and executive support.Conclusions:Teamwork is recommended to improve quality over the full cycle of care and consequently patient outcomes. Increased recognition of the value of an integrated team approach for skull base pathologies will hopefully encourage centers, physicians, allied health caregivers, and scientists devoted to treating these patients and advancing the field of knowledge to invest the time, effort, and resources to optimize and organize their collective expertise.

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Critical path analysis in head and neck cancer: a management technique for surgical oncology

Cited by 5 publications

References 10 publications

Interventions to reduce times to diagnosis and treatment of head and neck cancer: A systematic review and narrative synthesis

Interventions to reduce times to diagnosis and treatment of head and neck cancer: A systematic review and narrative synthesis

Effect of process standards on survival of patients with head and neck cancer in the south and west of England

Teamwork in skull base surgery: An avenue for improvement in patient care

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