Improving access through Innovation
Process/System Re-design
System Navigation: Cancer Program Access Coordinator (CPAC) & Referral Form
Tina MacDonald, Colleen Reaume, Moyez Jadavji, Ken Schneider, Allan Forse
Windsor Regional Cancer Centre/ Windsor Regional Hospital
Problem
Results
Conclusions
Knowledge Transfer
A significant barrier for expediting
cancer assessment and treatment is sub
optimal prioritizing of acuity of patients
afflicted
with
colorectal
disease.
Evidence exists that waiting times to
cancer treatment may impact on survival
and there is little doubt that increased
waiting time has major effects on the
emotional well being of patients and
families facing this disease.
In addition, Windsor and Essex County
has a significant shortage of family
physicians.
• changes to nurse’s history and
physical form to capture “date of initial
symptom”
• Clearer understanding of the
Privatization Act with a template letter
created for future project leaders to
utilize.
• Chart audit demonstrated:
-Appreciation from local physicians
that the cancer centre was taking an
active involvement in the community
for decreasing waiting times.
- Family physicians each have their
own distinct referral pattern.
-It is important to understand “how
physicians learn” when introducing
a new concept.
-Colonoscopies are a “territorial”
subject between surgeons and GI
specialists.
-Patients diagnosed with cancer are
still very anxious to learn about
preventive measures.
-Very clear that the local physician’s
here are very anxious for clear
colorectal screening guidelines to
follow.
The retrospective chart audit indicated
that a screening clinic would be
beneficial for the Windsor area to
streamline
diagnostic
tests.
Unfortunately the fast track tool was
not utilized in our community therefore
we were unable to compare data after
its implementation.
All
Objective
To promote education as well as the
creation of consistent/appropriate tools
for assessing and monitoring patient
flow for diagnostic / specialist referrals
for all patients in the suspected phase
for colorectal cancers.
Solution
Creation of a common “fast track”
referral form was designed. This form
can educate the family physicians on
what information is required for a good
assessment and this form also provides
the specialists with accurate information
for prioritization.
Part of this assessment included
education to both family physicians and
the public as well as a chart audit of all
new referrals to WRCC for colorectal
cancer.
A significant benefit was the
multidisciplinary team approach used
in the development of this pilot project.
A Steering Committee was developed
and was made up of Radiologists, GI
specialists, General Surgeons, and
Oncologists. This committee worked
collaboratively on processes for our
community to improve education for
primary care physicians, education
suggestions for the public, identifying
the need for provincial direction for
best practice to working on the highrisk
symptoms
and
processes
surrounding
“best
practice”
for
assessment for potential colorectal
cancers.
Lines of communication have been
significantly
improved
between
healthcare professionals as a result of
this project. Primary care physicians
have been provided with tools to help
them as caregivers to care for this
population of patients.
physicians within Windsor and
Essex County have received an
education package on colorectal
cancer, with a particular focus on the
physicians who work at the 25 walkin-clinics to offers tools and
information
on
appropriate
assessments
for
symptomatic
patients.
Lessons Learned
Lesson 1: Patients diagnosed with
cancer are still very anxious to learn
about preventive measures.
Lesson 2: Recognized the need to
change the nurse’s history and
physical form to capture “date of
initial symptom”
Lesson 3: Recognized the need to be
very familiar with the Privatization
Act/ Ethics policies
Lesson 4: Other professional colorectal
cancer organizations are anxious to
work with the cancer centre and
CCO
Lesson 5: Confirmation of CCO's
original FOBT report - stating the low
utilization of this colorectal cancer
test
Lesson 6: Concern with number of
patients coming into the hospital
emergency
room
with
severe
colorectal cancer symptoms (ie:
anemia, etc).
This percentage
matches a recent finding printed
within a Toronto newspaper, Summer
2005.