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Long-term effects of a regional care pathway for patients with rectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Introducing care pathways is seen as a method to realise patient-focussed care conform evidence-based guidelines. The goal of this study is to determine the long-term effects of a regional care pathway for patients with rectal cancer.

Patients and methods

Data on almost 400 patients with rectal carcinoma from three hospitals were obtained from the Netherlands Cancer Registry and the Dutch Surgical Colorectal Audit. Results on seven structure and process indicators were analysed and compared before and at two time points after implementing a regional care pathway over a total period from 2007 to 2012. To determine motivation and interpret the results, relevant professionals of the participating hospitals were interviewed.

Results

After implementing the care pathway, the performance of computed tomography (CT) scans in the diagnostic phase significantly improved (p = 0.007/0.07). The number of patients discussed in the preoperative multidisciplinary team (MDT) meeting improved significantly (p = <0.001), and after implementing the care pathway, 94 % of the patients were discussed. Further, a significant reduction in time between the first tumour biopsy and the MDT meeting was realised (p = 0.01). Professionals stated that the regional care pathway has led to more clarity about the patient route and more awareness about complying with evidence-based guidelines.

Conclusions

The regional care pathway provided a solid basis for uniforming care, working according evidence-based guidelines and further cooperation on regional level. For mainly the waiting and throughput times, the guidelines and norms had probably a stronger effect on the results than the care pathway.

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Acknowledgments

The authors thank the registration team of IKNL for the collection of data for the NCR as well as all professionals who contributed to this study.

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Authors and Affiliations

  1. Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands

    Jolanda C. van Hoeve, Marloes A. G. Elferink & Sabine Siesling

  2. Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands

    Joost M. Klaase

  3. Department of Surgery, Ziekenhuis Groep Twente, Almelo, The Netherlands

    Ewout A. Kouwenhoven

  4. Department of Internal Medicine, Streekziekenhuis Koningin Beatrix, Winterswijk, The Netherlands

    Pieter Paul J. B. M. Schiphorst

  5. Department Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands

    Sabine Siesling

  6. Netherlands Comprehensive Cancer Organisation, 9700 AH, Groningen, The Netherlands

    Jolanda C. van Hoeve

Authors
  1. Jolanda C. van Hoeve
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  2. Marloes A. G. Elferink
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  3. Joost M. Klaase
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  4. Ewout A. Kouwenhoven
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  5. Pieter Paul J. B. M. Schiphorst
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  6. Sabine Siesling
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Corresponding author

Correspondence to Jolanda C. van Hoeve.

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van Hoeve, J.C., Elferink, M.A.G., Klaase, J.M. et al. Long-term effects of a regional care pathway for patients with rectal cancer. Int J Colorectal Dis 30, 787–795 (2015). https://doi.org/10.1007/s00384-015-2209-7

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  • DOI: https://doi.org/10.1007/s00384-015-2209-7

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