Mr Scott StevensonOtolaryngologist - Head & Neck Surgeon, Canterbury DHB, Christchurch, NZ
Scott is a Christchurch based surgeon with public, private and university roles. He has sub-specialty interests in rhinology, anterior skull base surgery and sleep medicine/surgery. A past Examiner and Senior Examiner in ORL-HNS for the RACS, he remains heavily involved in both undergraduate and post-graduate education. He is the current NZ Deputy Chair of the Court of Examiners of the RACS.
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Audit of Waiting Times for Patients Attending the Christchurch Hospital New Patient Combined Head and Neck Cancer Clinic
Authors List:
Stevenson, S., Christchurch Hospital and University of Otago, Christchurch
Phillipson. J., University of Otago, Christchurch
Allison, R., Christchurch Hospital, Christchurch
Introduction: New Zealand guidelines recommend patients referred with high suspicion of Head and Neck Cancer (HNC) should have their First Specialist Appointment (FSA) within 14 days. Local experience suggests these guidelines are not being met and warrant review.
Aim: To audit referrals to the New Patient Combined Head and Neck Cancer Clinic (NPHNC) at the Canterbury District Hospital Board (CDHB), to determine whether recommended guidelines for timeframes are being met; to identify factors contributing to delays to FSA for patients with a new HNC.
Method: A retrospective observational study using electronic health records of patients seen in the CDHB NPHNC between 1st November 2018 and 1st November 2019. Data analysed for 188 patients included: age, gender, ethnicity, smoking status, location of cancer, referral source, DHB of domicile, referral prioritisation and days from referral to FSA; to determine which variables were associated with delays.
Results: 69.1% of NPHNC patients had primary care referrals prioritised as “Urgent” or “High Suspicion of Cancer”, only 52% of these patients had their FSA within 14 days. Of all NPHNC patients referred from primary care, only 43.6% had their FSA within 14 days. The variables associated with delays to FSA were: DHB of domicile, location of primary cancer, and gender.
Conclusion: Guidelines for time to FSA are not currently being met for patients seen in the CDHB NPHNC. Referral prioritisation is the key factor contributing to delays, improved awareness (and education) of the presentations of HNC may improve referrals. Even when referrals have appropriate prioritisation; recommended timeframes are not met. This may be improved by reducing inappropriate referral of the “worried well” (2).
Reference:
Tikka T, Pracy P, Paleri V. Refining the head and neck cancer referral guidelines: a two centre analysis of 4715 referrals. British Journal of Oral and Maxillofacial Surgery. 2016; 54(2): 141-150.
Authors List:
Stevenson, S., Christchurch Hospital and University of Otago, Christchurch
Phillipson. J., University of Otago, Christchurch
Allison, R., Christchurch Hospital, Christchurch
Introduction: New Zealand guidelines recommend patients referred with high suspicion of Head and Neck Cancer (HNC) should have their First Specialist Appointment (FSA) within 14 days. Local experience suggests these guidelines are not being met and warrant review.
Aim: To audit referrals to the New Patient Combined Head and Neck Cancer Clinic (NPHNC) at the Canterbury District Hospital Board (CDHB), to determine whether recommended guidelines for timeframes are being met; to identify factors contributing to delays to FSA for patients with a new HNC.
Method: A retrospective observational study using electronic health records of patients seen in the CDHB NPHNC between 1st November 2018 and 1st November 2019. Data analysed for 188 patients included: age, gender, ethnicity, smoking status, location of cancer, referral source, DHB of domicile, referral prioritisation and days from referral to FSA; to determine which variables were associated with delays.
Results: 69.1% of NPHNC patients had primary care referrals prioritised as “Urgent” or “High Suspicion of Cancer”, only 52% of these patients had their FSA within 14 days. Of all NPHNC patients referred from primary care, only 43.6% had their FSA within 14 days. The variables associated with delays to FSA were: DHB of domicile, location of primary cancer, and gender.
Conclusion: Guidelines for time to FSA are not currently being met for patients seen in the CDHB NPHNC. Referral prioritisation is the key factor contributing to delays, improved awareness (and education) of the presentations of HNC may improve referrals. Even when referrals have appropriate prioritisation; recommended timeframes are not met. This may be improved by reducing inappropriate referral of the “worried well” (2).
Reference:
Tikka T, Pracy P, Paleri V. Refining the head and neck cancer referral guidelines: a two centre analysis of 4715 referrals. British Journal of Oral and Maxillofacial Surgery. 2016; 54(2): 141-150.
