The impact of standardized care pathway on reporting time for invasive melanoma – results from one pathology department in Sweden

Margrét Agnarsdóttir,Helen Päären,Ismini Vassilaki

doi:10.1080/03009734.2019.1675102

Margrét Agnarsdóttir, Helen Päären + Show 1 more

Open Access

https://doi.org/10.1080/03009734.2019.1675102

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Abstract

Background: Standardized care pathway (SCP) was introduced by the Swedish health authorities to eliminate unwanted delay in the diagnostics of cancer patients; for melanoma, SCP started in 2016. The aim of this study was to investigate the impact of SCP on reporting time for invasive melanomas.Materials and methods: Information on reporting time was collected on all samples handled according to the SCP and on all invasive melanomas diagnosed in 2016–2018 at the Department of Clinical Pathology, Akademiska University Hospital, Uppsala, Sweden.Results: During the study period, 205 samples were handled according to the SCP, resulting in 53 cases (26%) diagnosed with invasive melanomas. A total of 301 invasive melanomas from 286 patients were diagnosed during the study period; 67 (22%) were submitted as SCP, 36 (12%) as a general priority case, and 198 (66%) as non-priority. The reporting time for the SCP cases was 8 days, for general priority cases 6 days, and for non-priority cases it was 24 days. The reporting time increased from 18 to 31 days for the non-priority cases and from 15 to 25 days for all cases with invasive melanomas during the study period.Conclusion: This study demonstrates prolonged reporting times for invasive melanomas since the implementation of SCP. This is probably caused by the crowd-out effect of the SCP samples, limited personnel resources, and inaccuracy of the clinical diagnosis. SCP might therefore be a suboptimal method to shorten reporting times for invasive melanomas.

Highlights

Invasive melanoma is the leading cause of skin-related deaths in the Western world [1,2]
A total of 205 cases were handled according to the Standardized care pathway (SCP) at the Department of Clinical Pathology
This study demonstrates prolonged reporting times for invasive melanomas since the implementation of SCP at a pathology department located at a university hospital in Sweden

Summary

Introduction

Invasive melanoma is the leading cause of skin-related deaths in the Western world [1,2]. For patients to be managed according to SCP, the pathology requisition is marked in a specific way These cases are treated as priority cases resulting in shorter reporting time but without any additional cost for the healthcare provider. Materials and methods: Information on reporting time was collected on all samples handled according to the SCP and on all invasive melanomas diagnosed in 2016–2018 at the Department of Clinical Pathology, Akademiska University Hospital, Uppsala, Sweden. A total of 301 invasive melanomas from 286 patients were diagnosed during the study period; 67 (22%) were submitted as SCP, 36 (12%) as a general priority case, and 198 (66%) as non-priority. Conclusion: This study demonstrates prolonged reporting times for invasive melanomas since the implementation of SCP This is probably caused by the crowd-out effect of the SCP samples, limited personnel resources, and inaccuracy of the clinical diagnosis. SCP might be a suboptimal method to shorten reporting times for invasive melanomas

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