Work-up times in an integrated brain cancer pathway

The integrated brain cancer pathway (IBCP) aims to ensure fast-track diagnostics and treatment for brain cancers in Denmark. This paper focuses on the referral pattern and the time frame of key pathway elements during the first two years following implementation of the IBCP in a regional neurology department.

All patients (n = 241) enrolled in the IBCP during the two-year period were included. Times from admission to completion of the key elements of the IBCP were used. The referral manner and changes in total neurology work-up time over eight quarters were assessed.

The monthly patient enrollment decreased over the eight quarters studied. Primary care physicians accounted for nearly half of referrals, while one-third were referred from other hospital departments. The mean time from admission to end of diagnostic work-up fell from three days (0-10 days) to two days (0-6 days). Within 24 hours of admission, all patients were seen by a specialist in neurology, 90% had an electrocardiogram and 93% had the required blood-work performed. 94% of the included patients had magnetic resonance imaging of the cerebrum performed.

The diagnostic process which was accelerated in the study-period and the total work-up time were generally low throughout. Key work-up items are currently being completed timely. Further improvements are possible. The enrollment rate has fallen to what we expect will be a steady level.

This study was funded by a grant from the Danish Ministry of Health and Interior Affairs 2009 and the Helen Rude Foundation and was approved by the Danish Data Protection Agency.

not relevant.