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Related Experiment Video

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Orthotopic Mouse Model of Colorectal Cancer
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Improving colorectal cancer referrals.

Claire Gregory1

  • 1The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK.

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|January 31, 2018
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Summary

Implementing a telephone assessment clinic (TAC) significantly reduced colorectal cancer referral to colonoscopy times. This quality improvement initiative streamlined patient pathways, decreasing wait times by 6 days initially and ultimately to 19 days.

Keywords:
PDSAcolorectal cancerhealthcare quality improvementsurgerytelephone assessment clinic

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Area of Science:

  • Colorectal surgery
  • Healthcare quality improvement
  • Oncology patient pathways

Background:

  • National Institute for Health and Care Excellence (NICE) guidance in June 2015 increased demand for fast-track colorectal referrals.
  • The Royal Bournemouth Hospital's colorectal services faced challenges meeting this increased demand.
  • Existing patient pathways resulted in an average 30-day wait from General Practitioner (GP) referral to colonoscopy.

Purpose of the Study:

  • To improve the timeliness of colonoscopy for fast-track colorectal referrals.
  • To reduce the patient waiting time from GP referral to colonoscopy.
  • To implement and evaluate a telephone assessment clinic (TAC) model.

Main Methods:

  • Utilized a Plan-Do-Study-Act (PDSA) methodology for iterative improvement.
  • Established a telephone assessment clinic (TAC) to triage patients directly to colonoscopy.
  • Collected data on referral-to-colonoscopy times across multiple PDSA cycles.

Main Results:

  • Initial PDSA cycles (1 and 2) reduced the average wait time from 30 days to 24 days (a 6-day improvement).
  • Subsequent PDSA cycle (3) further reduced the average wait time to 19 days.
  • The intervention also led to a reduction in the variation of wait times.

Conclusions:

  • A telephone assessment clinic (TAC) model is effective in reducing wait times for fast-track colorectal referrals.
  • The TAC model improves efficiency within the 62-day cancer patient pathway.
  • The TAC role has been established as a permanent position, ensuring sustainable improvements.