Examination of care processes and treatment optimization for head and neck cancer patients in a community setting “hub and hub” model

Abstract Objective To examine referral pattern, the timing of diagnostic/staging processes, and treatment initiation for new head and neck cancer patients in a community setting. Methods Patients with a newly diagnosed previously untreated diagnosis of head neck cancer managed at Asplundh Cancer Pav...

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Main Authors: Harleen K. Sethi, Elijah Walker, Travis Weinsheim, Matthew J. Brennan, Christopher E. Fundakowski
Format: Article
Language:English
Published: Wiley 2022-06-01
Series:World Journal of Otorhinolaryngology-Head and Neck Surgery
Subjects:
Online Access:https://doi.org/10.1002/wjo2.14
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author Harleen K. Sethi
Elijah Walker
Travis Weinsheim
Matthew J. Brennan
Christopher E. Fundakowski
author_facet Harleen K. Sethi
Elijah Walker
Travis Weinsheim
Matthew J. Brennan
Christopher E. Fundakowski
author_sort Harleen K. Sethi
collection DOAJ
description Abstract Objective To examine referral pattern, the timing of diagnostic/staging processes, and treatment initiation for new head and neck cancer patients in a community setting. Methods Patients with a newly diagnosed previously untreated diagnosis of head neck cancer managed at Asplundh Cancer Pavilion/Abington Memorial Hospital from October 2018 to March 2020. Source of referral and preceding workup were examined as well as intervals between initial head and neck consult and various timepoints of treatment initiation. Results One hundred and five patients were included in the study. The primary referral sources were external general otolaryngology (56.3%). Oral surgery and dermatology obtained tissue biopsy approximately 80% of the time before referral. The average time from the ordering of initial staging positron emission tomography/computed tomography to finalized results was 14 days (range: 10–25 days). Patients referred from dermatology and oral surgery were more likely to require single modality care, namely definitive surgical management. Time to treatment initiation average was 37 days (range: 29–41 days). Patients with longer treatment times noted significantly higher times to both radiation and medical oncology consults (48.42 vs. 18.13 days; P < 0.001). Conclusions No notable differences in treatment initiation times were identified based on referral source or extent of workup performed before head/neck surgery consult. It appears the largest opportunities for improvement in terms of reducing overall treatment length exist in the optimization of radiation initiation time.
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spelling doaj.art-8e053333bfa04fd88477c8d2983437e32023-08-29T18:05:48ZengWileyWorld Journal of Otorhinolaryngology-Head and Neck Surgery2095-88112589-10812022-06-018215215710.1002/wjo2.14Examination of care processes and treatment optimization for head and neck cancer patients in a community setting “hub and hub” modelHarleen K. Sethi0Elijah Walker1Travis Weinsheim2Matthew J. Brennan3Christopher E. Fundakowski4Department of Otolaryngology‐Head and Neck Surgery Sidney Kimmel Cancer Center at Abington—Jefferson Health Willow Grove Pennsylvania USACollege of Applied Health Science, University of Illinois at Urbana‐Champaign Urbana Illinois USADepartment of Otolaryngology‐Head and Neck Surgery Sidney Kimmel Cancer Center at Abington—Jefferson Health Willow Grove Pennsylvania USADepartment of Otolaryngology‐Head and Neck Surgery Sidney Kimmel Cancer Center at Abington—Jefferson Health Willow Grove Pennsylvania USADepartment of Otolaryngology‐Head and Neck Surgery Sidney Kimmel Cancer Center at Abington—Jefferson Health Willow Grove Pennsylvania USAAbstract Objective To examine referral pattern, the timing of diagnostic/staging processes, and treatment initiation for new head and neck cancer patients in a community setting. Methods Patients with a newly diagnosed previously untreated diagnosis of head neck cancer managed at Asplundh Cancer Pavilion/Abington Memorial Hospital from October 2018 to March 2020. Source of referral and preceding workup were examined as well as intervals between initial head and neck consult and various timepoints of treatment initiation. Results One hundred and five patients were included in the study. The primary referral sources were external general otolaryngology (56.3%). Oral surgery and dermatology obtained tissue biopsy approximately 80% of the time before referral. The average time from the ordering of initial staging positron emission tomography/computed tomography to finalized results was 14 days (range: 10–25 days). Patients referred from dermatology and oral surgery were more likely to require single modality care, namely definitive surgical management. Time to treatment initiation average was 37 days (range: 29–41 days). Patients with longer treatment times noted significantly higher times to both radiation and medical oncology consults (48.42 vs. 18.13 days; P < 0.001). Conclusions No notable differences in treatment initiation times were identified based on referral source or extent of workup performed before head/neck surgery consult. It appears the largest opportunities for improvement in terms of reducing overall treatment length exist in the optimization of radiation initiation time.https://doi.org/10.1002/wjo2.14head and neck cancerpackage timereferral sourcetime to treatment initiationtotal treatment length
spellingShingle Harleen K. Sethi
Elijah Walker
Travis Weinsheim
Matthew J. Brennan
Christopher E. Fundakowski
Examination of care processes and treatment optimization for head and neck cancer patients in a community setting “hub and hub” model
World Journal of Otorhinolaryngology-Head and Neck Surgery
head and neck cancer
package time
referral source
time to treatment initiation
total treatment length
title Examination of care processes and treatment optimization for head and neck cancer patients in a community setting “hub and hub” model
title_full Examination of care processes and treatment optimization for head and neck cancer patients in a community setting “hub and hub” model
title_fullStr Examination of care processes and treatment optimization for head and neck cancer patients in a community setting “hub and hub” model
title_full_unstemmed Examination of care processes and treatment optimization for head and neck cancer patients in a community setting “hub and hub” model
title_short Examination of care processes and treatment optimization for head and neck cancer patients in a community setting “hub and hub” model
title_sort examination of care processes and treatment optimization for head and neck cancer patients in a community setting hub and hub model
topic head and neck cancer
package time
referral source
time to treatment initiation
total treatment length
url https://doi.org/10.1002/wjo2.14
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