TY - JOUR
T1 - A multidisciplinary neuro-oncological triage panel reduces the time to referral and treatment for patients with a brain tumor
AU - de Swart, Merijn E.
AU - Kouwenhoven, Mathilde C. M.
AU - Hellingman, Tessa
AU - Kuiper, Babette I.
AU - Gorter de Vries, Cathelijne
AU - Leembruggen-Vellinga, Machteld
AU - Maliepaard, Niels K.
AU - Wouda, Ernest J.
AU - Moraal, Bastiaan
AU - Noske, David P.
AU - Postma, Tjeerd J.
AU - Sanchez Aliaga, Esther
AU - Uitdehaag, Bernard M. J.
AU - Vandertop, William P.
AU - Zonderhuis, Barbara M.
AU - Kazemier, Geert
AU - de Witt Hamer, Philip C.
AU - Schuur, Maaike
N1 - Publisher Copyright: © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background: Regional collaboration and appropriate referral management are crucial in neuro-oncological care. Lack of electronic access to medical records across health care organizations impedes interhospital consultation and may lead to incomplete and delayed referrals. To improve referral management, we have established a multidisciplinary neuro-oncological triage panel (NOTP) with digital image exchange and determined the effects on lead times, costs, and time investment. Methods: A prospective cohort study was conducted from February 2019 to March 2020. All newly diagnosed patients referred to Brain Tumor Center Amsterdam were analyzed according to referral pathway: (1) standard referral (SR), (2) NOTP. The primary outcome was lead time, defined as time-To-referral, time-To-Treatment, and total time (median days [interquartile range]). Secondary outcomes were costs and time investment. Results: In total, 225 patients were included, of whom 153 had SR and 72 NOTP referral. Patients discussed in the NOTP were referred more frequently for first neurosurgical consultation (44.7% vs 28.8%) or combined neurological and neurosurgical consultation (12.8% vs 2.5%, P =. 002). Time-To-referral was reduced for NOTP referral compared to SR (1 [0.25-4] vs 6 [1.5-10] days, P <. 001). Total time decreased from 27 [14-48] days for the standard group to 15 [12-38.25] days for the NOTP group (P =. 040). Costs and time investment were comparable for both groups. Conclusion: Implementation of digital referral to a multidisciplinary NOTP is feasible and leads to more swift patient-Tailored referrals at comparable costs and time investment as SR. This quality improvement initiative has the potential to improve collaboration and coordination of multidisciplinary care in the field of neuro-oncology.
AB - Background: Regional collaboration and appropriate referral management are crucial in neuro-oncological care. Lack of electronic access to medical records across health care organizations impedes interhospital consultation and may lead to incomplete and delayed referrals. To improve referral management, we have established a multidisciplinary neuro-oncological triage panel (NOTP) with digital image exchange and determined the effects on lead times, costs, and time investment. Methods: A prospective cohort study was conducted from February 2019 to March 2020. All newly diagnosed patients referred to Brain Tumor Center Amsterdam were analyzed according to referral pathway: (1) standard referral (SR), (2) NOTP. The primary outcome was lead time, defined as time-To-referral, time-To-Treatment, and total time (median days [interquartile range]). Secondary outcomes were costs and time investment. Results: In total, 225 patients were included, of whom 153 had SR and 72 NOTP referral. Patients discussed in the NOTP were referred more frequently for first neurosurgical consultation (44.7% vs 28.8%) or combined neurological and neurosurgical consultation (12.8% vs 2.5%, P =. 002). Time-To-referral was reduced for NOTP referral compared to SR (1 [0.25-4] vs 6 [1.5-10] days, P <. 001). Total time decreased from 27 [14-48] days for the standard group to 15 [12-38.25] days for the NOTP group (P =. 040). Costs and time investment were comparable for both groups. Conclusion: Implementation of digital referral to a multidisciplinary NOTP is feasible and leads to more swift patient-Tailored referrals at comparable costs and time investment as SR. This quality improvement initiative has the potential to improve collaboration and coordination of multidisciplinary care in the field of neuro-oncology.
KW - lead times
KW - quality improvement
KW - referral
KW - telehealth
KW - triage panel
UR - http://www.scopus.com/inward/record.url?scp=85117376035&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/nop/npab040
DO - https://doi.org/10.1093/nop/npab040
M3 - Article
C2 - 34589232
SN - 2054-2577
VL - 8
SP - 559
EP - 568
JO - Neuro-Oncology Practice
JF - Neuro-Oncology Practice
IS - 5
ER -