Introduction: There is significantly less access to specialist healthcare services in regional settings. This is the case in cancer patients who travel greater distances with less resources that results in poorer coordination of care. This study was done to assess patient pathways, optimise patient flow and identify areas of weakness for improvement.
Methods: Retrospective data of patients diagnosed with gastrointestinal cancer or breast cancer receiving care in the Gippsland Region was collected from 2016 to 2018. The data was collected from administrative data-bases. The data collected included date of GP referral to specialist, diagnosis, date of surgery, date of MDM meeting, date first seen by an oncologist and date of chemotherapy commencement.
Results: 100 gastrointestinal and breast cancer patients were included. The data is in the process of being analysed. Initial analysis of 82 breast and colorectal cancer patients showed the mean number of days from the date of diagnosis to surgery was 44 days (7-214 days) for breast cancer and 55 days (1-104 days) for colorectal cancer patients; and cancer diagnosis to the start of chemotherapy was 64 days (16-260 days) and 70 days (9-369 days) for colorectal and breast cancer respectively. Further detailed analysis of 15 colorectal cancer patients showed the mean time from the date of GP referral to the date of diagnosis was 40 days (18-183 days) and to the date of surgery 53 days (1-111 days). The mean time from diagnosis or surgery to initial multidisciplinary meeting (MDM) was 10 days. (1-16 days) The mean time from MDM to first oncology appointment was 19 days (6-31 days) and then to initiation of chemotherapy 16 days (6-25 days).
Conclusion: Initial results, from the cohort, suggest that the greatest time is spent from the GP referral date to the date of diagnosis and flow from MDM to starting treatment is more streamlined. Detailed analysis of patient pathway will help to improve patient outcomes and experience.