scholarly journals 1648 Is Telephone Triage Here to Stay? An Audit of The Impact of COVID 19 On A Head and Neck Cancer Clinic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Osuji ◽  
V Srinivasan
Keyword(s):  
Cancer Patients ◽  
Neck Cancer ◽  
Medical Records ◽  
Treatment Initiation ◽  
District General Hospital ◽  
Telephone Triage ◽  
Significant Drop ◽  
Retrospective Audit ◽  
The Impact ◽  
Cancer Clinic

Abstract Due to the COVID19 pandemic, NHS reported a 60% drop in suspected cancer referrals and a delay in treatment initiation. In a pandemic, cancer waiting time (WT) targets can prove difficult to achieve. ENT UK and NHS England recommended a senior-led telephone triage system to be put in place in response to the pandemic. Aim of this audit was to assess the impact of the pandemic and evaluate the efficacy of tele-consults on the Head & Neck Cancer (H&N) Service at a District General Hospital. A retrospective audit of patients referred to the H&N clinic from April - June 2020, comparing patients managed by teleconsultations to patients seen F2F. Medical records were analysed to assess compliance with NHS Cancer WT targets. 2020 saw a 1.4% drop in referrals compared to 2019. Of the 224 referrals received from April - June 2020, 96.9% were seen within 14 days. 98.7% were initially reviewed by telephone, 37% of which were triaged to a F2F appointment, 39% were followed up by telephone and 24% were discharged or given routine appointments. 11.2% were diagnosed with cancer. Comparing cancer patients managed by telephone to patients seen F2F, 80% v 57% received a diagnosis by 28 days from the referral, and 100% v 17% started treatment by 62 days. The department did not have a significant drop in referrals due to the COVID pandemic. Cancer patients managed by telephone were more likely to start treatment within 62 days. Telephone consults should be a permanent feature of cancer clinics beyond the pandemic.

Patient burden of centralization of head and neck cancer surgery

2004 ◽  
Vol 118 (7) ◽  
pp. 528-531 ◽  
Author(s):  
R.S. Patel ◽  
Julie Hewett ◽  
S.A. Hickey
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
District General Hospital ◽  
Median Number ◽  
Retrospective Audit ◽  
Regional Cancer Centre ◽  
The Uk ◽  
The Impact ◽  
Patient Burden

This study was undertaken to assess the impact on patients of proposals to centralize head and neck oncology services in the UK. A retrospective audit of the 2001–2002 head and neck cancer database at South Devon district general hospital identified 85 patients (50 males: 35 females; median age 66 years; range 29–93) diagnosed with head and neck cancer. The total number of hospital visits for diagnostic, therapeutic and other management services were recorded (median number of visits 28; range 1–78). Using this data, the extra distance required to travel to a potential regional cancer centre located in Bristol during the first six months of management was extrapolated. It was calculated that each patient would have to travel on average an extra 5333 miles (median 5658; range 185–13 759). Published documents advocating centralization of oncology services make no reference to the patient burden of geographic relocation of medical services. Agencies involved with restructuring oncology services must recognize the non-clinical impact of centralization and make some provision to overcome the burden facing patients and their carers.

scholarly journals The hidden curve behind COVID-19 outbreak: the impact of delay in treatment initiation in cancer patients and how to mitigate the additional risk of dying – the head and neck cancer model

2020 ◽  
Author(s):  
Leandro L. Matos ◽  
Carlos Henrique Q. Forster ◽  
Gustavo N. Marta ◽  
Gilberto Castro Junior ◽  
John A. Ridge ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Treatment Initiation ◽  
Additional Risk ◽  
Time To Treatment ◽  
Time To Treatment Initiation ◽  
Risk Of Cancer ◽  
The Impact

Abstract Purpose: The rapid spread of the SARS-CoV-2 pandemic around the world caused most healthcare services to turn substantial attention to treatment of these patients and also to alter the structure of healthcare systems to address an infectious disease. As a result, many cancer patients had their treatment deferred during the pandemic, increasing the time to treatment initiation, the number of untreated patients (which will alter the dynamics of healthcare delivery in the post-pandemic era) and increasing their risk of death. Hence, we analyzed the impact on global cancer mortality considering the decline in oncology care during the COVID-19 outbreak using head and neck cancer, a known time-dependent disease, as a model. Methods: An online practical tool capable of predicting the risk of cancer patients dying due to the COVID-19 outbreak and also useful for mitigation strategies after the peak of the pandemic has been developed, based on a mathematical model. The scenarios were estimated by information of 15 oncological services worldwide, given a perspective from the five continents and also some simulations were conducted at world demographic data. Results: The model demonstrates that the more that cancer care was maintained during the outbreak and also the more it is increased during the mitigation period, the shorter will be the recovery, lessening the additional risk of dying due to time to treatment initiation. Conclusions: This impact of COVID-19 pandemic on cancer patients is inevitable, but it is possible to minimize it with an effort measured by the proposed model.

scholarly journals End-Of-Life Discussions Reduce The Utilization of Life-Sustaining Treatments During The Last Three Months of Life in Cancer Patients : A Nationwide Population-Based Cohort Study

2021 ◽  
Author(s):  
Shang-Yih Chan ◽  
Yun-Ju Lai ◽  
Yu-Yen Hsin Chen ◽  
Shuo-Ju Chiang ◽  
Yi-Fan Tsai ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiopulmonary Resuscitation ◽  
End Of Life ◽  
Cancer Patients ◽  
Medical Records ◽  
Population Based ◽  
Lower Likelihood ◽  
The Mean ◽  
The Impact ◽  
To Receive

Abstract Purpose Studies to examine the impact of end-of-life (EOL) discussions on the utilization of life-sustaining treatments near death were limited and had inconsistent findings. This nationwide population-based cohort study determined the impact of EOL discussions on the utilization of life-sustaining treatments in the last three months of life in Taiwanese cancer patients. Methods This cohort study included adult cancer patients from 2012–2018, which were confirmed by pathohistological reports. Life-sustaining treatments during the last three months of life included cardiopulmonary resuscitation, intubation, and defibrillation. EOL discussions in cancer patients were confirmed by their medical records. Association of EOL discussions with utilization of life-sustaining treatments were assessed using multiple logistic regression. Results Of 381,207 patients, the mean age was 70.5 years and 19.4% of the subjects utilized life-sustaining treatments during the last three months of life. After adjusting for other covariates, those who underwent EOL discussions were less likely to receive life-sustaining treatments during the last three months of life compared to those who did not (Adjusted odds ratio [AOR]: 0.82; 95% confidence interval [CI]: 0.80–0.84). Considering the type of treatments, EOL discussions correlated with a lower likelihood of receiving cardiopulmonary resuscitation (AOR = 0.43, 95% CI: 0.41–0.45), endotracheal intubation (AOR = 0.87, 95%CI: 0.85–0.89), and defibrillation (AOR = 0.52, 95%CI: 0.48–0.57). Conclusion EOL discussions correlated with a lower utilization of life-sustaining treatments during the last three months of life among cancer patients. Our study supports the importance of providing these discussions to cancer patients to better align care with preferences during the EOL treatment.

A nurse-led telephone triage for the prevention and control of COVID-19 spread in an oncology department.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e13617-e13617
Author(s):  
Lorenzo Calvetti ◽  
Francesca Simionato ◽  
Alessandro Cappetta ◽  
Francesca La Russa ◽  
Roberta Cimenton ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Cancer Patients ◽  
Health Workers ◽  
Veneto Region ◽  
Telephone Triage ◽  
Period 2 ◽  
Anticancer Treatment ◽  
Hospital Acquired ◽  
And Control ◽  
The Impact

e13617 Background: After the results of the Nurse-led Telephone Triage (NTT) study ( Calvetti L, et al. ASCO 2020), the system has been implemented to prevent unnecessary hospitalizations of cancer patients. With the pandemic outbreak, a dedicated SARS-CoV-2 2019 (COVID-19) NTT protocol was added to monitor cancer patients (CPs) receiving active medical treatment. We report on the impact of NTT in limiting accesses and minimizing the risk of spread of the infection through the Department of Oncology. Methods: CPs on active medical treatment were educated to call the NTT in case of any symptoms suspected for COVID-19 infection to the Oncology Department of Vicenza, Italy, during the COVID-19 pandemic (February 22 2020 to January 31, 2021). Each event assessment was performed by trained oncology nurses with the supervision of a medical oncologist on duty and in case of suspected COVID-19 infection a testing pathway for COVID-19 was activated. Primary endpoint of this study was to compare incidence of COVID-19 and related deaths in both CPs on active medical treatment and health workers with the rate in the overall population of Veneto region. Results: From February 22 2020 to January 31, 2021 1,154 patients received systemic anticancer treatment (versus 1,022 patients in the same 2019 – 2020 period). Total consultations at NTT were 587; 97 patients reported symptoms suspected for COVID-19 infections. The COVID-19 testing pathway was launched in 60 CPs and a positive test was reported in 25 CPs (2.2% incidence compared to 6.5% in the overall Veneto region population). Two COVID-19 related deaths were reported (8% death rate). In the same period, 2/54 (3.7%) health workers tested positive for COVID-19. Patients who tested positive had a median treatment delay of 25 days. Conclusions: The NTT system in the clinical practice provided a useful tool for monitoring and limiting hospital-acquired COVID-19 infection among both CPs on active treatment and health workers.

scholarly journals Impact of Tracheal Tube on Swallowing in Post-Operative Head and Neck Cancer Patients: Scintigraphic Analysis

Dysphagia ◽  
2020 ◽  
Author(s):  
Jacopo Galli ◽  
Maria Raffaella Marchese ◽  
Tiziana Di Cesare ◽  
Laura Tricarico ◽  
Giovanni Almadori ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Tracheal Tube ◽  
Transit Time ◽  
Neck Cancer ◽  
Retention Index ◽  
Small Diameter ◽  
Swallowing Rehabilitation ◽  
The Impact

AbstractDysphagia is common in tracheostomized patients who underwent head and neck surgery for cancer treatment. The objective of this study was to evaluate, by means of oropharyngoesophageal scintigraphy (OPES), the impact of an occluded tracheal tube (TT) on swallowing in patients treated for head and neck cancer before hospital discharge, to provide further information to the benefit of out-patient care management. From October 2018 to November 2019, we enrolled 19 tracheostomized patients (6 females and 13 males; mean age 61 years) who underwent primary surgical resection of head and neck tumor and swallowing rehabilitation during hospitalization. All subjects underwent a double-standard OPES, one with occluded tracheal tube and the other without TT, with their tracheal stoma being closed directly by a plaster. For each study, we assessed and compared the following quantitative parameters: oral transit time (OTTsec), pharyngeal transit time (PTTsec), esophageal transit time (ETTsec), oral retention index (ORI%), pharyngeal retention index (PRI%), esophageal retention index (ERI%), and aspiration percentage (AP%). The mean values of OTT, PTT, ORI%, PRI%, and ERI% were abnormal during OPES both with TT and without TT and did not statistically differ between the two tests (p > 0.05). Aspiration was detected in 4 cases out of 19 (21.05%) cases during OPES with TT and in 4/19 (21.05%) cases without TT who showed a mean AP% of 11.4% and 11.5% respectively (p > 0.05). Patients with abnormal AP% (> 0%) during OPES with TT showed aspiration signs without TT. Our study showed that the mere presence of a closed tracheal tube does not impact significantly the oropharyngeal transit of bolus during swallowing. This result suggests the possibility to maintain a small-diameter occluded tracheal tube in place for the postsurgical management of head and neck cancer patients.

scholarly journals The impact of the COVID-19 pandemic on head and neck cancer patients

Oral Oncology ◽  
2020 ◽  
Vol 110 ◽  
pp. 104881 ◽  
Author(s):  
Gaili Chen ◽  
Qiuji Wu ◽  
Huangang Jiang ◽  
Yahua Zhong
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
The Impact

The impact of taste and smell alterations on quality of life in head and neck cancer patients

2015 ◽  
Vol 25 (6) ◽  
pp. 1495-1504 ◽  
Author(s):  
M. Alvarez-Camacho ◽  
S. Gonella ◽  
S. Ghosh ◽  
C. Kubrak ◽  
R. A. Scrimger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
The Impact ◽  
Taste And Smell
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