Skin lesion assessment and management model: optimising existing resources in the management of non-melanoma skin cancer

Abstract

Abstract 
 Background
 Skin cancer is a relatively common cancer in Australia, with early, simple treatment conferring a high likelihood of cure. Early diagnosis and treatment are important to reduce morbidity and mortality. A see-and-treat clinic seeks to offer earlier diagnosis and treatment as compared with a traditional model of care. The aim was to implement this model using pre-existing infrastructure with a hypothesis that this service will reduce wait times with reduced costs and high levels of patient satisfaction 
 
 Methods
 Referrals were screened and those suitable underwent consultation with a Plastic and Reconstructive Surgeon and same-day operative management with their choice of anaesthesia. Patients were reviewed 1 week and 4 weeks postoperatively.
 
 Results
 206 patients had 286 skin lesions removed over 23 operating lists. Over 75% of excisions were on the face. Local anaesthetic with sedation was the most popular anaesthetic technique There were 22 complications and the incomplete excision rate was 4.2%. Average wait time for SLAM-suitable patients reduced by 76%, and category 1 outpatient waitlists were reduced by 100%. An estimated gross saving of $1,339 per patient was calculated. A survey of patients post-operatively showed all patients would recommend this model.
 
 Conclusion
 This see-and-treat model was shown to reduce wait times and cost, along with high levels of patient satisfaction. It was also easily implemented using pre-existing infrastructure. It is a service that continues to be offered and expanded, with ongoing patient satisfaction.