Toustrup Kasper, Lambertsen Karin, Ulhøi Benedicte Parm, Sørensen Leif, Sørensen Hanne Birke, Grau Cai
Afdelingen for Eksperimentel Klinisk Onkologi, Arhus Sygehus, Nørrebrogade 44, bygn. 9, DK-8000 Arhus C, Denmark.
Ugeskr Laeger. 2010 Jan 25;172(4):279-84.
Acceleration of diagnosis and initiation of treatment for head and neck cancer requires optimal organisation and multidisciplinary collaboration. A project at the Head and Neck Oncology Centre, Aarhus University Hospital aimed at accelerating patient flow.
The initiatives were implemented throughout 2007. Focus was on optimizing logistics for all patients referred to the centre with suspected head and neck cancer. Initiatives included a full-time coordinator, pre-booked slots for clinical work-up and weekly tumour boards. Key dates were registered and relevant intervals were quantitatively evaluated and compared to a reference group from 2006.
We registered 446 patients. Waiting times for first clinical examination at the ENT department were reduced from medially eight to two days through 2007 (p < 0.0001). Time from first clinical examination to referral for treatment was reduced from medially 21 to nine days (p < 0.0001). Time from referral to treatment to initiation of treatment was reduced from medially 26 to 15 days (p < 0,001). The net result of these reductions was a reduced overall median time (from primary referral to initiation of treatment) from medially 57 days by end of 2006 to medially 29 days by end of 2007 (p < 0,0001).
Logistic changes and especially introduction of a full-time coordinator, a multidisciplinary tumour board and a generally higher priority for head and neck cancer patients resulted in a significant acceleration regarding diagnosis and start of treatment from 2006 to 2007.
加速头颈癌的诊断和治疗启动需要优化组织架构和多学科协作。奥胡斯大学医院头颈肿瘤中心开展了一个旨在加速患者流程的项目。
各项举措于2007年全年实施。重点是优化所有疑似头颈癌而转诊至该中心患者的后勤保障。举措包括设立一名全职协调员、为临床检查预先安排时段以及每周召开肿瘤病例讨论会。记录关键日期，并对相关间隔进行定量评估，与2006年的参照组进行比较。
我们登记了446名患者。2007年，耳鼻喉科首次临床检查的等待时间从平均8天减至2天（p < 0.0001）。从首次临床检查到转诊治疗的时间从平均21天减至9天（p < 0.0001）。从转诊治疗到开始治疗的时间从平均26天减至15天（p < 0.001）。这些减少的综合结果是，总体中位时间（从初次转诊到开始治疗）从2006年底的平均57天减至2007年底的平均29天（p < 0.0001）。
后勤保障的改变，特别是设立全职协调员、多学科肿瘤病例讨论会以及对头颈癌患者普遍给予更高优先级，使得2006年至2007年在诊断和治疗开始方面有了显著加速。
