Abstract

IntroductionTimely access to cancer treatment is expected to improve patients’ satisfaction and treatment outcome. A joint multidisciplinary breast cancer clinic (JMDBCC) was developed in January 2011 which aimed to accelerate access to breast cancer care. Here, we assess the efficacy of this approach.MethodsMetric data of access to care in 2010 represent the pre-JMDBCC era while those during the subsequent 5 years (2011–2015 inclusive) represent the post-JMDBCC era. The JMDBCC is comprised of three separate but closely adjacent subclinics conducted at the same time representing the three main relevant clinic-based disciplines supported by a breast cancer coordinator. The primary aim of the clinic is to provide service to new patients within 7 days at each of the following stages: acceptance to first clinic visit (S1), first clinic visit to completion of appropriate investigations (S2), and completion of investigations to start of active treatment (S3). Thus, the total duration from acceptance to treatment (S1-3) is aimed to be within 21 days.ResultsFive hundred and fifty visits to the relevant clinics were recorded at the pre-JMDBCC era. Mean time metrics for new patients were as follows: 13, 18, 21, and 46 days for S1, S2, S3, and S1-3, respectively. The JMDBCC achieved reduction in all time metrics from the first year of implementation, reaching 3.6, 4.9, 7.3, and 15.9 days for S1, S2, S3, and S1-3, respectively, in year 2015. The number of new patients and total recorded clinic visits increased from 49/550, respectively, in the pre-JMDBCC era to 92/654, 183/1816, 158/2797, 174/4426, and 180/5883 in subsequent years.ConclusionsA JMDBCC dramatically accelerates access to specialist multidisciplinary care. All institutions managing patients with breast cancer are encouraged to adopt such a coordinated service. The impact of an effective JMDBCC on disease-specific outcome should be addressed in future studies.

Highlights

  • Access to cancer treatment is expected to improve patients’ satisfaction and treatment outcome

  • Introduction of Breast cancer (BC) Multidisciplinary care (MDC) care is associated with improved survival and reduced variation in outcome among hospitals [3]

  • The aim of the clinic is to provide service to new patients within 7 days at each of the following stages: acceptance to first clinic visit (S1), first clinic visit to completion of appropriate investigations (S2), and completion of investigations to start of active treatment (S3)

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Summary

Introduction

Access to cancer treatment is expected to improve patients’ satisfaction and treatment outcome. A joint multidisciplinary breast cancer clinic (JMDBCC) was developed in January 2011 which aimed to accelerate access to breast cancer care. Multidisciplinary care (MDC) is a team approach to the provision of healthcare by all relevant medical and allied health disciplines. MDC is accepted as a standard approach to manage patients with cancer including that of the breast. MDTMs will promote interdisciplinary communication, but eventually patients will still be reviewed by relevant specialist in different clinics. This will result in multiple clinic visits and time and resource wastage. A joint multidisciplinary breast cancer clinic (JMDBCC) is likely to overcome these challenges. A JMDBCC was developed at the author’s institution in January 2011 aiming to accelerate access to breast cancer care. This study was undertaken to evaluate the clinic in reference to its intended goal, namely (a) waiting times metrics and (b) clinic capacity

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