Increasing Referrals of Patients With Gastrointestinal Cancer to a Cancer Rehabilitation Program: A Quality...

Area of Science:

• Oncology
• Rehabilitation Medicine
• Quality Improvement Science

Background:

• Cancer patients face significant long-term effects from cancer and treatments.
• Cancer rehabilitation (CR) aims to mitigate these effects and optimize patient function.
• A multidisciplinary CR program had low referral rates for gastrointestinal (GI) cancer patients.

Purpose of the Study:

• To increase CR referrals for GI cancer patients by 50% in 2019 compared to 2018.
• To increase the proportion of GI cancer CR referrals originating from oncologists.
• To monitor inappropriate referrals and cancellations as balancing measures.

Main Methods:

• A rapid cycle improvement approach using Plan-Do-Study-Act (PDSA) cycles was implemented over 12 months.
• Barriers to GI cancer CR referral were identified via literature review and clinician interviews.
• Interventions included program advertisement, staff education, patient outreach, and clinician engagement.

Main Results:

• A 100% relative increase in GI cancer CR referral numbers was observed.
• The proportion of referrals from oncologists increased from 51% to 75%.
• No significant changes were noted in inappropriate referrals or cancellations.

Conclusions:

• PDSA cycles effectively improved GI cancer referrals to the CR program.
• The study successfully increased both the volume of referrals and the rate of oncologist-initiated referrals.
• Future efforts will focus on sustaining these improvements in cancer rehabilitation access.