Innovating service delivery with 'One-Stop' prostate cancer clinics to reduce cancer pathway breaches
BAUS ePoster online library. Luscombe C. 06/25/19; 259490; P12-6
Christopher Luscombe
Christopher Luscombe
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Abstract
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Introduction:
Prostate cancer is the most common cancer in men in the UK. Given referral caseload, the consultations, investigations and procedures required to establish diagnosis, meeting national cancer targets for diagnosis and treatment is challenging. After process-mapping current practice, we instigated a 'one-stop' referral pathway in December 2017, to include consultation, examination, mpMRI and TRUS biopsy in one visit. One-stop and standard cancer referral patient journeys were compared.

Patient/Methods:
We performed a retrospective cross-sectional analysis of 24 patients (12 'one-stop' and 12 'standard' cancer pathway). Clinical and demographic data, acceptability questionnaires and times to investigation and treatment were recorded.


Results:

In the standard referral pathway, mean times to MRI, TRUS biopsy and TRUS result clinic were 4, 24 and 41 days respectively; and times to decision to treat (DTT) and treatment start (TS) were 66 and 77 days (exceeding national targets). In the one-stop pathway, mean times to MRI, TRUS biopsy and TRUS result clinic were 0, 0 and 7 days respectively; mean times to DTT and TS were 27 and 45 days. All one-stop pathway wait times were significantly shorter (p<0.05, T-Test). 10/12 patients strongly preferred the one-stop pathway. 42% prostate cancer referral breaches were avoided using the one-stop pathway.

CONCLUSION

Early data suggest the one-stop pathway is preferred by patients and leads to significantly shorter waiting times and time to investigation. Delays remain where patients require/request thinking time prior to treatment. Introducing our one-stop clinic has made significant improvements in meeting national targets and reducing pathway breaches.
Introduction:
Prostate cancer is the most common cancer in men in the UK. Given referral caseload, the consultations, investigations and procedures required to establish diagnosis, meeting national cancer targets for diagnosis and treatment is challenging. After process-mapping current practice, we instigated a 'one-stop' referral pathway in December 2017, to include consultation, examination, mpMRI and TRUS biopsy in one visit. One-stop and standard cancer referral patient journeys were compared.

Patient/Methods:
We performed a retrospective cross-sectional analysis of 24 patients (12 'one-stop' and 12 'standard' cancer pathway). Clinical and demographic data, acceptability questionnaires and times to investigation and treatment were recorded.


Results:

In the standard referral pathway, mean times to MRI, TRUS biopsy and TRUS result clinic were 4, 24 and 41 days respectively; and times to decision to treat (DTT) and treatment start (TS) were 66 and 77 days (exceeding national targets). In the one-stop pathway, mean times to MRI, TRUS biopsy and TRUS result clinic were 0, 0 and 7 days respectively; mean times to DTT and TS were 27 and 45 days. All one-stop pathway wait times were significantly shorter (p<0.05, T-Test). 10/12 patients strongly preferred the one-stop pathway. 42% prostate cancer referral breaches were avoided using the one-stop pathway.

CONCLUSION

Early data suggest the one-stop pathway is preferred by patients and leads to significantly shorter waiting times and time to investigation. Delays remain where patients require/request thinking time prior to treatment. Introducing our one-stop clinic has made significant improvements in meeting national targets and reducing pathway breaches.

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