National Improvement of Waiting Times: First Results From the Dutch Head and Neck Audit

Abstract Objective Timely treatment initiation in head and neck cancer (HNC) care is of great importance regarding survival, oncological, functional, and psychological outcomes. Therefore, waiting times are assessed in the Dutch Head and Neck Audit (DHNA). This audit aims to assess and improve the quality of care through feedback and benchmarking. For this study, we examined how waiting times evolved since the start of the DHNA. Study Design Prospective cohort study. Setting National multicentre study. Methods The DHNA was established in 2014 and reached national coverage of all patients treat... Mehr ...

Verfasser: van Oorschot, Hanneke Doremiek
de Jel, Dominique Valérie Clarence
Hardillo, Jose Angelito
Smeele, Ludi E.
Baatenburg de Jong, Robert Jan
Dokumenttyp: Artikel
Erscheinungsdatum: 2023
Reihe/Periodikum: Otolaryngology–Head and Neck Surgery ; volume 170, issue 3, page 766-775 ; ISSN 0194-5998 1097-6817
Verlag/Hrsg.: Wiley
Schlagwörter: Otorhinolaryngology / Surgery
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27079783
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : http://dx.doi.org/10.1002/ohn.532

Abstract Objective Timely treatment initiation in head and neck cancer (HNC) care is of great importance regarding survival, oncological, functional, and psychological outcomes. Therefore, waiting times are assessed in the Dutch Head and Neck Audit (DHNA). This audit aims to assess and improve the quality of care through feedback and benchmarking. For this study, we examined how waiting times evolved since the start of the DHNA. Study Design Prospective cohort study. Setting National multicentre study. Methods The DHNA was established in 2014 and reached national coverage of all patients treated for primary HNC in 2019. DHNA data on curative patients from 2015 to 2021 was extracted on national (benchmark) and hospital level. We determined 3 measures for waiting time: (1) the care pathway interval (CPI, first visit to start treatment), (2) the time to treatment interval (TTI, biopsy to start treatment), and (3) CPI‐/TTI‐indicators (percentage of patients starting treatment ≤30 days). The Dutch national quality norm for the CPI‐indicator is 80%. Results The benchmark median CPI and TTI improved between 2015 and 2021 from 37 to 26 days and 37 to 33 days, respectively. Correspondingly, the CPI‐ and TTI‐indicators, respectively, increased from 39% to 64% and 35% to 40% in 2015 to 2021. Outcomes for all hospitals improved and dispersion between hospitals declined. Four hospitals exceeded the 80% quality norm in 2021. Conclusion Waiting times improved gradually over time, with 4 hospitals exceeding the quality standard in 2021. On the hospital‐level, process improvement plans have been initiated. Systematic registration, auditing, and feedback of data support the improvement of quality of care.