Researchers have found that length of time between cancer diagnosis and treatment initiation may affect survival in certain settings, particularly for patients with early-stage breast cancer, lung cancer, and pancreatic cancer.1 Furthermore, treatment initiation can lead to greater anxiety, decreased satisfaction with care, and overall poorer quality of life for patients.2-4

Currently, the goal of England’s National Health Service is to treat all patients within approximately 2 months of diagnosis (though this target is frequently not met).5 In the United States, large academic treatment centers have a median time to treatment initiation of about 6 weeks.6,7

Despite the fact that rising rates of cancer diagnosis and increasing population size, coupled with escalation cost of treatment, are exacerbating existing pressures on the health care system, delays in time to treatment initiation are primarily related to policy. 

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To help address this issue, researchers at the Cleveland Clinic’s Taussig Cancer Institute designed a process-based approach to reduce time to treatment initiation among patients treated at their center.8 The results of the case study, which were recently published in NEJM Catalyst, showed that the approach could lower median wait times by 13 days.

“Our cancer center Chair (and my coauthor) Brian Bolwell, MD, focused on prioritizing time to treatment for all cancer patients entering our institution,” said Alok Khorana, MD, of the Taussig Cancer Institute in Cleveland, Ohio, in an interview with Cancer Therapy Advisor. “We created and supported teams with data infrastructure, regular meetings, huddles, program managers, and patient navigators. We were able to do this in the environment of the Cleveland Clinic where teams are organized around disease sites.”

The authors noted that they viewed this initiative as a “quality improvement measure,” which did not require a large amount of financial resources to trial. They created a “Team of Teams” to improve communication among practitioners in subspecialties; this was done through weekly meetings of the schedulers involved in an individual patient’s care. This technique improved transparency and allowed data to be reported and shared more easily, which in turn increased the speed of treatment scheduling and initiation.