Implementing large scale fast track diagnostics in a comprehensive cancer center, pre- and post-measurement data

Area of Science:

• Oncology
• Operations Management
• Healthcare Systems Engineering

Background:

• Cancer diagnosis often involves multiple patient visits, leading to delays.
• The Netherlands Cancer Institute (NKI) initially implemented fast track diagnostics in 2006 using operations management techniques.
• Increased patient volume and process complexity necessitated an expansion and optimization of these services.

Purpose of the Study:

• To decrease the number of patient visits required for cancer diagnosis.
• To extend fast track diagnostic services to all 18 cancer types with a minimum weekly incidence.
• To improve overall diagnostic efficiency and patient experience.

Main Methods:

• Redesigned diagnostic processes with multidisciplinary team involvement.
• Applied operations management principles including lean management, theory of constraints, and mathematical analysis.
• Organized diagnostic slots (MRI, CT, PET, echography) per tumor type and conducted pre- and post-implementation measurements (3 and 6 months).

Main Results:

• Pre-implementation access time was 10-15 workdays; mean throughput time was 6.0 workdays.
• Post-implementation, mean access time reduced to 8.2-8.7 workdays, and mean throughput time decreased to 3.3-3.4 workdays.
• Successfully implemented fast track diagnostics for 18 tumor types, with 7 achieving "one-stop shop" status.

Conclusions:

• Fast track diagnostics considerably shortened patient throughput and access times for 18 cancer types.
• Physician involvement in work reorganization and responsive support during implementation were critical success factors.
• The optimized process improved diagnostic efficiency and potentially reduced patient anxiety associated with prolonged diagnostic journeys.