Ezairjawi, H. and Sultana, A. (2022) Reducing the Time from Diagnosis to Treatment in Patients with Colorectal Liver Metastases. HPB, 24 . S545-S546. ISSN 1365182X
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Official URL: https://doi.org/10.1016/j.hpb.2022.05.1181
Abstract
Introduction: Approximately 33% of patients with colorectal cancer (CRC) are diagnosed with liver metastases (CRLM). The Hospital Episode Statistic data from 2018-2019 identified suboptimal performance in managing CRLM cases at East Lancashire Teaching Hospitals NHS Trust (ELHT).
Aim: To reduce the waiting time for patients with CRLM, from referral to treatment, by 15% over six months without compromising the quality of care.
Method: A retrospective audit was conducted to gather data regarding the service before the COVID-19 pandemic. From this, a change idea was developed and planned to be implemented using a plan-do-study-act approach.
Results: Audit results showed that, on average, the waiting time for CRLM treatment is 77 days. This is markedly higher than the England rapid assessment and treatment target of 62 days. In addition, 90% of patients were found to have undergone PET-CT scans as part of the disease staging, which was found to cause case discussion and treatment delays. Results indicate that PET-CT scans showed new findings in 19% of the cases only.
Discussion: The change idea was not implemented due to the COVID-19 pandemic and the time limitation. The proposed idea is to create a pathway that helps clinicians determine the need for PET-CT scans depending on each patient's clinical picture.
Conclusion: PET-CT scans have little impact on managing operable CRLM cases and no role in managing inoperable patients. Therefore, local guidelines should be adjusted to move from unnecessary routine use of PET-CT scans. This would reduce treatment waiting time and improve outcomes.
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