2008 Annual Meeting Abstracts
Upper GI Multidisciplinary Cancer Program and Efficiency and Quality of Care
Laurence E. McCahill, M.D.1, Alicia Privette, M.D.1, Nicole Messier, R.N.2, Joan Blondin2.
1University of Vermont, Burlington, VT, USA, 2Fletcher Allen Healthcare, Burlington, VT, USA.
Objective: Patients with newly diagnosed upper gastrointestinal (UGI) cancers present to a variety of medical professions, enhancing opportunity for disparities in diagnostic evaluation and treatment. In order to provide expeditious and evidence based clinical care, we developed an UGI multidisciplinary cancer (MDC) program: treatment planning conference, MDC clinic and a dedicated Nurse Navigator (NN). We sought to evaluate the impact of this new approach.
Design: Prospective Observational Study
Setting: Tertiary Care, academic medical center
Patients: All patients referred to UGI MDC program from Feb 2007- March 2008.
Interventions: NN as lead in organizational structure of Cancer care delivery
Main Outcomes Measures:
1) Days from diagnosis to completion of all diagnostic studies
2) Days until clinical staging evaluation completed
3) Days to physician evaluation
4) Days to initiation of cancer therapy
5) % of patients presented at MDC treatment planning conference
6) % of patients treated in compliance with NCCN Guidelines
119 patients (53 pancreatic, 23 esophageal, 11 gastric, 18 liver, 14 other) with newly diagnosed UGI malignancies were evaluated and treated.
Mean days until completion of diagnostic studies was 5.8, until evaluation in MDC clinic was 5.6, and until initiation of therapy was 17.1.
90% of patients had treatment plans reviewed at MDC conference. 73% saw all necessary physicians for evaluation on a single day. 96% were treated according to 2007 NCCN guidelines.
Conclusion: A formal approach to MDC care for patients with UGI malignancies has allowed for both rapid evaluation and treatment, and high compliance with evidence based guidelines. A NN can streamline complex cancer care when multiple physicians are required.