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Published byAnabel Ross Modified over 9 years ago
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Quality in Cancer Surgery Dr. Craig McFadyen VP Cancer Services, Grand River Hospital Regional VP (Waterloo-Wellington), Cancer Care Ontario Medical Director Surgical Oncology, Grand River Regional Cancer Center Director Waterloo-Wellington Breast Assessment Unit
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What is Quality ? Patient – Surgical treatment as soon as possible Surgeon – 30 day mortality and morbidity Pathologist – Well oriented intact tissue Medical/Radiation Oncologist – Concise path report, clear margins, healthy patient
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Quality Right thing, the right way, at the right time, every time.
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Quality in Surgery How do we measure it? What can we measure? Do these mean anything? How do we fix deficiencies?
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Access Wait Times
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Wait Times, a Primer
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Access W 1 = Referral to consultation W 2 = Consultation to treatment
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Wait Times W 2 – Consultation – Investigations Direct Due diligence – Wait time from decision to to treat until surgery
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But what about the wait time that really matters to the patient? The total time from symptom to treatment Diagnostic Assessment Units – Skin – Breast – Lung
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Waterloo Wellington Breast Assessment Unit
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Standards in Treatment
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CCO, the Program for Evidenced Based Care and Surgical Standards
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Colorectal Cancer Standards Preop evaluation Margins Lymph node retrieval Rectal Cancer
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Colorectal Cancer Standards Preop evaluation Margins Lymph node retrieval Rectal Cancer
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Colorectal Cancer Standards Preop evaluation Margins Lymph node retrieval Rectal Cancer
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Colorectal Cancer Standards Preop evaluation Margins Lymph node retrieval Rectal Cancer – TME – Neoadjuvant treatment
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Standards- Institutions The volume - quality relationship
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Institutional Standards
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Thoracic Surgery – St Mary's Hepatic/Biliary and Pancreatic – Grand River
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Standards Pathology Reporting Synoptic Reporting
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Standards Care Multidisciplinary Case Conferences
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Data and Feedback Wait times Rectal Cancer MCC’s
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Data and Feedback Wait times Rectal Cancer MCC’s
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Data and Feedback Wait times Rectal Cancer MCC’s
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Future Clinical guidelines for – Prostate Cancer – Breast Cancer (Sentinel Lymph node biopsy) – Gastric Cancer – Melanoma
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Questions
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