Optimizing workflows for metastatic central nervous system disease: a systematic review and proposed guidelines

Area of Science:

• Neuro-oncology
• Clinical Operations
• Translational Research

Background:

• Brain and spine metastases significantly increase morbidity and mortality in cancer patients.
• Optimizing patient workflow is crucial for enhancing care alongside medical, surgical, and radiation therapies.
• This study presents the first systematic review to identify workflow optimization opportunities and propose guidelines for operational excellence.

Purpose of the Study:

• To systematically review existing literature on workflow optimization for brain and spine metastases.
• To identify critical points for improving patient care pathways.
• To develop guidelines for operational excellence in managing metastatic brain and spine disease.

Main Methods:

• A systematic literature search was conducted across PubMed/MEDLINE, Embase, and Web of Science.
• Studies evaluating optimization points in treatment workflows for metastatic brain and spine disease were included.
• Data on study design, outcomes, and bias were extracted and analyzed.

Main Results:

• Thirty studies involving 23,697 patients were included.
• Key areas identified include patient education, surgical referrals, and radiation/medical oncology coordination.
• Expediting triaging, referral speed, and treatment initiation showed significant benefits, supported by clinical teams and AI.

Conclusions:

• Optimizing workflows is essential for improving outcomes in metastatic brain and spine disease.
• Guidelines are proposed for a standardized and comprehensive patient workflow.
• Future research should focus on these critical areas to further enhance patient care quality.