Keywords:
Musculoskeletal system, Oncology, CT, MR, Biopsy, Cancer, Neoplasia
Authors:
A. Nobre, T. Lloyd, M. Lowe, E. Knox; Brisbane, QLD/AU
DOI:
10.26044/ranzcr2021/R-0329
Results
A total of 322 cases over the 6-month period met inclusion criteria. Comparing the pre-DSMDT and post-DSMDT group respectively, the average number of new patient referrals that were seen increased by 79.5% from 39 to 70 per month. These figures incorporate a true increase in numbers as well as formalising of previous “corridor consultation,” cases. This ensures a more robust process without the risk of patients being lost to the system.
- The average time for the first formalised management plan to be developed decreased from an average of 39 days (pre-DSMDT) to 7.4 days (post-DSMDT). It should be noted that these results are an average of all referrals and that the most urgent referrals in the pre-DSMDT were triaged to be seen earlier than the 39-day average (pre-DSMDT).
- In the pre-DSMDT group there was a total of 16 patients who failed to attend (FTA) their appointments and were required to be rebooked. These FTAs accounted for 12% of all patients booked in the pre-DSMDT sarcoma clinic.
Benefits of DSMDT
- All new referrals must contain appropriate imaging transferred to the electronic imaging system.
- Streamlined referral system, supervised by dedicated Sarcoma CNC. All appropriate referrals are seen at next DSMDT meeting the following Friday.
- Dedicated MSK Radiologist and Orthopaedic Oncology Surgeon present to develop a comprehensive plan.
- Imaging is available at time of DSMDT meeting for MSK radiologist to review.
- Decision regarding biopsy modality (imaging guided vs surgical) and approach planned. No requirement for further appointments to plan the biopsy by radiology on a separate occasion.
- No travel cost, patients are not physically present and hence this solves the issue of patients failing to attend their appointments. This process selects patients that require to travel to a tertiary centre for treatment and allows other cases if appropriate to be managed at patient’s base hospital. This results in a more judicious use of health funds by saving on travel costs.
- No clinic space requirement and less staffing requirement compared to patient’s being seen in clinic.
- Please refer to the flow charts (Fig 2,3) describing the referral and diagnostic process of pre-DSMDT and post DSMDT implementation.