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INTEGRATED CARE PATHWAYS IN LUNG CANCER: A QUALITY IMPROVEMENT PROJECT

Published online by Cambridge University Press:  06 February 2018

Gianpiero Fasola
Affiliation:
Department of Oncology
Jessica Menis
Affiliation:
Department of Oncology
Alessandro Follador
Affiliation:
Department of Oncology
Elisa De Carlo
Affiliation:
Department of Oncologyelisa.decarlo84@gmail.com
Francesca Valent
Affiliation:
Department of Hygiene and Epidemiology
Giuseppe Aresu
Affiliation:
Department of Thoracic Surgery
Alessandro De Pellegrin
Affiliation:
Department of Pathology
Francesco Giacomuzzi
Affiliation:
Department of Nuclear Medicine
David Iuri
Affiliation:
Department of Radiology
Emilio Lugatti
Affiliation:
Department of Pneumology
Giuseppe Parisi
Affiliation:
Department of Radiotherapy
Guglielmo Pacileo
Affiliation:
Centre for Research on Health and Social Care Management (CERGAS)

Abstract

Background: Non small cell lung cancer (NSCLC) diagnosis and treatment is a highly complex process, requiring managerial skills merged with clinical knowledge and experience. Integrated care pathways (ICPs) might be a good strategy to overview and improve patient's management. The aim of this study was to review the ICPs of NSCLC patients in a University Hospital and to identify areas of quality improvement.

Materials and Methods: The electronic medical records of 169 NSCLC patients visited at the University Hospital were retrospectively reviewed. Quality of care (QoC) has been measured trough fifteen indicators, selected according main international Guidelines and approved by the multi-disciplinary team for thoracic malignancies. Results have been compared with those of a similar retrospective study conducted at the same hospital in 2008.

Results: A total of 146 patients were considered eligible. Eight of fifteen indicators were not in line with the benchmarks. We compared the results obtained in the two separate periods. Moreover, we process some proposal to be discussed with the general management of the hospital, aimed to redesign NSCLC care pathways.

Conclusions: ICPs confirm to be feasible and to be an effective tool in real life. The periodic measurement of QoC indicators is necessary to ensure clinical governance of patients pathways.

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Copyright
Copyright © Cambridge University Press 2018 

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