October 2016 VOL 7, NO 9

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Category III: Quality, Outcomes, and Performance Improvement, Seventh Annual AONN+ Conference Abstracts

12. Can Time to Treatment Be Improved for Lung Cancer Patients by Having Their Case Presented at a Thoracic Multidisciplinary Conference?

Wendy L. Brooks, RN; Dawn M. Deacon, RN, BSN, OCN; Lindsey M. Reed, RN, BSN, OCN
Sarah Cannon Cancer Network – HCA Midwest Health 

Background: A positive impact is seen in the timeliness to treatment for cancer patients presented at a thoracic multidisciplinary conference. “Timeliness of treatment delivery is one of the key performance indicators of quality care in lung cancer, and there are a number of studies demonstrating that the multidisciplinary model improves time between diagnosis and initiation of treatment. Timely treatment is considered particularly important in lung cancer, as tumors have rapid doubling times, and delays in treatment may result in upstaging and worse outcomes for patients,” and “Health services research that includes studies of patterns of care in lung cancer treatment has identified measures of quality treatment in lung cancer. These include...time between diagnosis and initiation of treatment.”1According to Scher and colleagues, “Studies showed that multidisciplinary care is associated with decreased time between diagnosis and treatment.”2

Purpose: Show that presentation at a thoracic multidisciplinary conference improves timeliness from diagnosis to treatment.

Methods: Sarah Cannon is the oncology service-line for HCA. Sarah Cannon’s proprietary software, iNavigate, is used by oncology nurse navigators to document key data points, including date of diagnosis, date of first treatment, and if patients are presented at a multidisciplinary conference. Midwest division market data were obtained for a 5-month period from January to May 2016 and was reported by month and time to treatment in days. We compared the average time to treatment for our cohort of patients with the total number of lung cancer patients diagnosed in this time frame. The average time to treatment was 20 days.

Results: It was observed over a 5-month period, 19 patients presented at a thoracic multidisciplinary conference were diagnosed with lung cancer and had an overall 35% improvement in timeliness to care from an average of 20 days to 13 days, thus portraying the benefit of improved timeliness to treatment for cancer patients presented at multidisciplinary conference.

Conclusion: Multidisciplinary conference, a requirement for accreditation by the American College of Surgeons Commission on Cancer, has become part of the standard of care for many programs. The improved timeliness to treatment demonstrates the benefit of a multidisciplinary conference to our thoracic program and patients.

Implications/Limitations: Increasing evidence suggests that multidisciplinary conferences improve outcomes. More quality studies are needed to prove that multidisciplinary conferences improve cancer care quality indicators across disease sites and to identify the barriers to successful multidisciplinary care.

References

  1. Denton E, Conron M. Improving outcomes in lung cancer: the value of the multidisciplinary health care team. J Multidiscip Healthc. 2016;9:137-144.
  2. Scher KS, Tisnado DM, Rose DE, et al. Physician and practice characteristics influencing tumor board attendance: results from the provider survey of the Los Angeles Women’s Health Study. J Oncol Pract. 2011;7:103-110.
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