Long-term effects of a regional care pathway for patients with rectal cancer

Hoeve, Jolanda C. van; Elferink, M.A.G.; Klaase, Joost M.; Kouwenhoven, Ewout A.; Schiphorst, P. P.; Siesling, Sabine

doi:10.1007/s00384-015-2209-7

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…Since 2004, rectal cancer guidelines were introduced in the Netherlands and recommended that all patients are discussed in a multidisciplinary team (MDT). This has been effectuated and implemented on a nationwide scale successfully with improved quality of care as a result [18][19][20]. A regional expert MDT meeting have been shown to alter initial treatment plan frequently in upper-GI malignancies [21].…”

Section: Discussionmentioning

confidence: 99%

Hospital variance in neoadjuvant rectal cancer treatment and the influence of a national guideline update: Results of a nationwide population-based study

Köeter

Elferink

Verhoeven

et al. 2020

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Hospital variance in neoadjuvant rectal cancer treatment and the influence of a national guideline update: Results of a nationwide population-based study

Köeter

Elferink

Verhoeven

et al. 2020

Radiotherapy and Oncology

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“…Experts included a representative from the Netherlands Comprehensive Cancer Organisation (IKNL), who was researching pathways in oncology, and those from the cancer centers. 17,18 Stakeholders of the BENCH-CAN project (eg, clinicians and [quality] managers) and experts from other cancer centers (OECI members, n=71) were then asked for feedback and a consensus was reached on the indicator set (step 8), containing 51 qualitative indicators and 193 quantitative indicators. Indicators assessed multiple topics concerning the organization of cancer care pathways, specifically those for breast and colorectal cancers, with a focus on organizational aspects of care pathways, not the clinical interpretation.…”

Section: Indicator Development and Collectionmentioning

confidence: 99%

Benchmarking Cancer Centers: From Care Pathways to Integrated Practice Units

Wind

Gonçalves

Marosi

et al. 2018

J Natl Compr Canc Netw

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Structuring cancer care into pathways can reduce variability in clinical practice and improve patient outcomes. International benchmarking can help centers with regard to development, implementation, and evaluation. A further step in the development of multidisciplinary care is to organize care in integrated practice units (IPUs), encompassing the whole pathway and relevant organizational aspects. However, research on this topic is limited. This article describes the development and results of a benchmark tool for cancer care pathways and explores IPU development in cancer centers. The benchmark tool was developed according to a 13-step benchmarking method and piloted in 7 European cancer centers. Centers provided data and site visits were performed to understand the context in which the cancer center operates and to clarify additional questions. Benchmark data were structured into pathway development and evaluation and assessed against key IPU features. Benchmark results showed that most centers have formalized multidisciplinary pathways and that care teams differed in composition, and found almost 2-fold differences in mammography use efficiency. Suggestions for improvement included positioning pathways formally and structurally evaluating outcomes at a sufficiently high frequency. Based on the benchmark, 3 centers indicating that they had a breast cancer IPU were scored differently on implementation. Overall, we found that centers in Europe are in various stages of development of pathways and IPUs, ranging from an informal pathway structure to a full IPU-type of organization. A benchmark tool for care pathways was successfully developed and tested, and is available in an open format. Our tool allows for the assessment of pathway organization and can be used to assess the status of IPU development. Opportunities for improvement were identified regarding the organization of care pathways and the development toward IPUs. Three centers are in varying degrees of implementation and can be characterized as breast cancer IPUs. Organizing cancer care in an IPU could yield multiple performance improvements.

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“…Technical information exchange and regular communication flow between all those involved in treatment (including patients, general practitioners, specialist physicians, and other specialty disciplines) is needed [ 8 ]. Therefore, care pathways are often used in cancer care and are seen as a method to provide patient-centered care, reduce waiting times, and improve quality of cancer care [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis

et al. 2020

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Background Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and meta-analysis aiming to identify and synthesize existing literature on the effects of pathways in oncological care. Methods All patients diagnosed with cancer in primary and secondary/tertiary care whose treatment can be characterized as the strategy “care pathways” are included in this review. A systematic search in seven databases was conducted to gather evidence. Studies were screened by two independent reviewers. Study outcomes regarding patients, professionals, and system level were extracted from each study. Results Out of 13,847 search results, we selected 158 articles eligible for full text assessment. One hundred fifty studies were excluded and the remaining eight studies represented 4786 patients. Most studies were conducted in secondary/tertiary care. Length of stay (LOS) was the most common used indicator, and was reported in five studies. Meta-analysis based on subgroups showed an overall shorter LOS regarding gastric cancer (weighted mean difference (WMD)): − 2.75, CI: − 4.67 to − 0.83) and gynecological cancer (WMD: − 1.58, CI: − 2.10 to − 1.05). Costs were reported in six studies and most studies reported lower costs for pathway groups. Conclusions Despite the differences between the included studies, we were able to present an evidence base for cancer care pathways performed in secondary/tertiary care regarding the positive effects of LOS in favor of cancer care pathways. Systematic review registration PROSPERO CRD42017057592.

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Long-term effects of a regional care pathway for patients with rectal cancer

Cited by 7 publications

References 8 publications

Hospital variance in neoadjuvant rectal cancer treatment and the influence of a national guideline update: Results of a nationwide population-based study

Hospital variance in neoadjuvant rectal cancer treatment and the influence of a national guideline update: Results of a nationwide population-based study

Benchmarking Cancer Centers: From Care Pathways to Integrated Practice Units

Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis

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