Gynaecological cancer pathway for faster cancer treatment: a repeat clinical audit.

AIMS: This clinical audit aimed to review cancer management pathways for patients with gynaecological cancers in Northland in order to evaluate whether there has been an improvement compared to previous audit periods and look for differences between ethnicities. METHODS: 186 Northland patients with a new diagnosis of gynaecological cancer were discussed at the Auckland gynaecology-oncology multidisciplinary meeting (MDM) between 1 January 2018 and 31 December 2020. Patient demographics and data pertaining to cancer care was collected and compared to datapoints set out in the original audit, derived from the Ministry of Health Faster Cancer Treatment (FCT) targets and standards of service provision. RESULTS: 89.2% of patients had their first treatment within 31 days of treatment decision, and 66.9% had their first treatment within 62 days of referral, an improvement compared to previous audit periods. Wait times were shorter but there were still delays in obtaining histology, MDM discussion and receiving treatment. There were also differences between treatment locations, as well as between Maori and non-Maori. CONCLUSIONS: There has been an overall improvement in gynaecological cancer service provision for Northland patients. However, outcomes still fall short of the national FCT targets and there are on-going disparities between Maori and non-Maori.

Faster Cancer Treatment pathway in gynaecological malignancy: a repeat clinical audit.

AIMS: This clinical audit aimed to review the Faster Cancer Tract pathway in Northland patients with gynaecological cancers to evaluate whether there has been an improvement since the previous audit in 2014-2015. METHODS: There were 46 patients who were discussed at the gynaecological oncology multidisciplinary meeting between January 2016 and December 2016 with confirmed gynaecological malignancy. Information regarding the time taken for various investigations, referrals, decisions and treatment to be completed for each patient was obtained from clinical records and compared against the Ministry of Health faster cancer treatment targets, standards of service provision and data from the previous audit. RESULTS: Overall, 85% of patients met the target of having their first treatment within 31 days of a decision being made for treatment. 45% of patients met the target of having their first treatment within 62 days of initial referral for suspected cancer. This reflects an overall improvement in service provision from the previous audit period, which showed targets being met in 73% and 39% of cases respectively. CONCLUSION: There has been an overall improvement in cancer care service provision for Northland patients since the previous audit, however it still falls short of the national FCT targets.

Gynaecological cancer pathway for faster cancer treatment: a clinical audit.

Gynaecological cancers make up 10% of cancer cases and 10% of female cancer deaths in New Zealand. The services for investigation and treatment of these women are regionally specific rather than centrally organised; hence we need appropriate standards of service and clear pathways for communication and management of these patients to ensure consistent care that is in line with the Ministry of Health goals for faster cancer treatment. AIM: The aim of this audit is to ensure faster gynaecological cancer management pathways for Northland patients. METHODS: There were 72 gynaecological cancer cases identified from the gynaecological oncology referral data. These were the patients referred for multidisciplinary discussion of their newly diagnosed gynaecological cancer from June 2014-June 2015. Seventeen cases were excluded from this audit. The patients' information regarding their health care during the investigation and treatment of their cancer was obtained via an electronic patient record system. The time taken for each patient to complete various investigation, referrals, decisions and treatment was then compared against Ministry of Health faster cancer treatment targets and standards of service provision. RESULTS: The results showed that the overall target of patients having their first treatment within 62 days of initial referral for suspected cancer was being met only in 39% of cases. The best performing area of the pathway was the time from first referral from Northland DHB until the date of the first MDM discussion for a patient with an aim of ≤14 days with 93% of cases meeting this. The worst performing area was the time from decision to biopsy for tissue diagnosis to the time the histology report was produced, aiming for ≤14 days. We met this target in only 35% of cases. CONCLUSION: Over half of Northland patients are not receiving treatment in time that meets national targets. This delay seems to be mainly at the tissue diagnosis stage especially if operative intervention is required and while waiting on a management plan from the multidisciplinary team. Further input into appropriate tracking of cancer patients, management of prioritisation of operating lists and perhaps increased theatre time for gynaecology cancer patients should be considered. Increasing the frequency of multidisciplinary meetings for management plan decisions to be made should also be considered. The standards for service provision should also be altered to have a time course for referral, investigation and management that is in line with the Ministry faster cancer treatment targets.