Improvement of time to develop treatment plan at a specialized sarcoma center.

Abstract

127 Background: Treatment of new patients at the MD Anderson Sarcoma Medical Oncology Clinic can take up to 1 to 2 weeks from their initial consultation depending on the information available for review. Treatment delays can result in poor patient outcomes, adversely affecting the quality of care provided. There are numerous processes involved in the development of a treatment plan that could be improved to reduce the time to finalization of treatment plan. Methods: We undertook a quality improvement project involving key clinic and administrative team members. We performed detailed process mapping and developed a cause and effect diagram to identify and prioritize opportunities for improvement. We measured the time in hours from the patient’s initial appointment to finalization of a treatment plan. Baseline data (before process improvement implementation) was collected retrospectively through chart review. Post-implementation data was collected prospectively. For process improvement, we focused on two deficiencies that were regarded as the key causes of delay to develop a finalized treatment plan (1) insufficient data for decision making at the time of new patient visit, and (2) delays in obtaining diagnostic imaging. Results: Due to insufficient data for decision-making available at the time of initial consultation, the median time to develop a treatment plan is 72 hours. After initiating process improvement, the median time to develop a treatment plan decreased to approximately 7 hours. Conclusions: Improving the quality of data available for the medical oncologist prior to initial consultation greatly enhances the rapid development of finalized treatment plan. Availability of an early treatment plan improves patient outcomes, diminishes patient anxiety, and decreases the costs incurred by the patient awaiting a treatment plan at a specialized oncology clinic.

Survival and Prognosis of Chondrosarcoma Subtypes: SEER Database Analysis

“…Our results highlight the differences in survival between non‐conventional chondrosarcoma subtypes, indicating that efforts to complete subtyping classification should be made whenever possible. The rarity of chondrosarcoma, along with the difficulty and importance of subtype classification support referral to specialized sarcomas treatment centers, which have demonstrated improved clinical outcomes . Given the informative data that can be gained from even limited databases, such as SEER, collaborative efforts between centers to establish a national database specific to sarcomas could be an important next step in advancing our understanding and care of chondrosarcoma in the United States.…”