West Coast patients diagnosed with breast cancer are now receiving faster treatment, following significant changes to the clinical pathway.Driven by patient feedback, West Coast DHB Cancer Nurse Coordinator Andrea Reilly set about making improvements when she started the role in mid-2013. The timeline has now been reduced from between 60 to 100 days, to within 31 days – from the patient’s first confirmed diagnosis of breast cancer outside screening, to surgery.
The project began after a patient questioned the amount of travelling and delays in getting her breast cancer treatment underway. “The most frequent thing I hear in my role is it’s the waiting that’s difficult,” Andrea says. “Some patients also had to take up to four long distance trips and it was quite distressing for them. This is the exact mandate for the Cancer Nurse Coordinator role – to be champions for the Faster Cancer Treatment programme, and make quality improvements to the patient’s journey. So that’s how it all started.”
Andrea examined the Breast Symptoms clinical pathway in HealthPathways, which provides general practice teams with information to consistently assess and manage medical conditions, as well as the criteria for requesting health services in West Coast DHB.Every step of the breast cancer pathway was evaluated, from a patient’s first appointment with their general practitioner. Andrea worked with clinicians and other health professionals to agree on changes made to the pathway. As a result, GPs are now able to order mammograms, rather than the patient being referred on to a general surgeon. Patients can also receive results straight from their GPs, and increased support and information is provided early in the process, Andrea says. “We’ve reduced waiting times and reduced the number of people the patient has to deal with. It’s also meant the general surgeons in our DHB are freed up in their capacity to see other patients. We’ve sped up the whole process, but in a safe and transparent way.”
Patients referred to Canterbury for surgery are also better informed. “This ensures patients are better prepared psychologically as well, and more easily able to cope with a very fast track service.”Andrea is currently looking at different tumour streams to see what changes could be made to ensure an easier patient journey. She says patient feedback is the best driver for change. “I encourage my patients to provide us with comment or complaint. If no one says anything, nothing changes. We might believe something needs improvement, but if we can get a consumer voice to back that up, it’s much easier to get the ball rolling.”