Wait Time from Diagnosis to Radiation Therapy | Description of Indicator | Median Wait times (in Days) from diagnosis to radiation therapy (for radical intent) for patients with oropharyngeal cancer (diagnosed 2014-2015) | | Figures/Graphs | Figures 1-3 | | Rationale for Measurement | - Measuring the time from diagnosis to radiation treatment captures a larger section of the patient journey. This may be more relevant from a patient perspective than other wait time intervals.
- Having relevant integrated measures, such as this, addresses the importance of coordination of care for patients in the cancer system
- As per CSQI 2016, variation was seen across regions, which suggests that there is room for improvement.
- Continuing to measure this indicator is important in order to further understand how long patients are waiting at various stages in their cancer journey (diagnosis to referral; referral to consult; consult to start of treatment). Ongoing measurement will inform us as to whether performance is improving or not.
- There is considerable variation from the consult date to date of first treatment. This is despite the fact that we are meeting provincial targets in Ready to Treat to Start of Treatment. This variation would again suggests there is room for improvement, presumably in the staging work up of patients and coordination of care with other related disciplines (medical oncology, surgery, dental, etc.)
- Enhancing our understanding of the regional variation may help to identify areas in which quality improvement initiatives would be beneficial and inform potential KTE/sharing of best practices between regions.
| | Evidence/References for Rationale | N/A | | Calculations for the Indicator | Median Wait times (in Days) from diagnosis to first treatment for patients with oropharyngeal cancer diagnosed in 2014 and 2015, and followed by receiving radiation therapy with radical intent in Ontario. Note that treatment year could take place after year 2015. Topography ICDO3 codes were using for consideration: | Topography ICDO3 code range | DescriptionC019 | | C019 | Base of Tongue | | C100 – C109 | Oropharynx | | C051 – C059 | Palate | | C090 – C099 | Tonsil | Topography code range above would be applied to Ontario Cancer Registry (OCR) for the initial selection of the cohort. The date of the first treatment for the same patients whoever were diagnosed in calendar years 2014 and 2015 would be used for diagnosis to treatment wait time calculation. Waiting time (in days) calculation from diagnosis to referral, from referral to consult, from consult to treatment and diagnosis to treatment were calculated by: | Wait time Type | Formula | | Diagnosis to Referral | Referral Date – Diagnosis Date | | Referral to Consult | Consult Date – Referral Date | | Consult to Treatment | Consult Date – First treatment Date | | Diagnosis to Treatment | First Treatment Date – Diagnosis Date | Regional and Ontario Median wait times (in days) for each year will then be calculated. | | Standardized Rate Calculation | N/A | | Unit | Median Wait Time (in days) | | Data Sources | Cancer Care Ontario, Ontario Cancer Registry (OCR) and Activity Level Reporting (ALR) | | Time Frame | Calendar Years 2014 and 2015 | | Geographic Scale | Regional Cancer Program | | Denominator Description | N/A | | Numerator Description | N/A | | Considerations | - Any patients with oropharyngeal cancer diagnosed during calendar years 2014 and 2015 and identified in Ontario Cancer Registry were included;
- Cases with valid diagnosis dates, treat dates (Radical Intent) are only considered as valid cases for this analysis.
- Oropharyngeal cases are identified in OCR based on cases with selected Topography Code;
- Selected clinical practice groups (i.e. palate, Tonsil, Base of tongue and oropharynx) are used to identify Oropharyngeal cancer cases with radiation therapy in ALR.
- Not all RCC’s treat Head and Neck.
- Patients who have single or multiple primary cancer will be included in this indicator.
- Waterloo Wellington and North Simcoe Muskoka Regional Cancer Centre are excluded from the median wait time calculation.
| | Data Availability & Limitations | Consult to ready to treat and ready to treat to treatment intervals were collapsed due to data limitations. |
Wait Time from Diagnosis to Radiation Therapy | Description of Indicator | Median Wait times (in Days) from diagnosis to radiation therapy (with radical intent) for patients with cervical cancer (diagnosed 2014-2015) | | Figures/Graphs | Figures 4-6 | | Rationale for Measurement | - Measuring the time from diagnosis to radiation treatment captures a larger section of the patient journey. This may be more relevant from a patient perspective than other wait time intervals.
- Having relevant integrated measures, such as this, addresses the importance of coordination of care for patients in the cancer system
- There is considerable variation from the consult date to date of first treatment. This is despite the fact that we are meeting provincial targets in Ready to Treat to Start of Treatment. This variation would again suggests there is room for improvement, presumably in the staging work up of patients and coordination of care with other related disciplines (medical oncology, surgery, dental, etc.)
- Enhancing our understanding of the regional variation may help to identify areas in which quality improvement initiatives would be beneficial and inform potential KTE/sharing of best practices between regions.
| | Evidence/References for Rationale | N/A | | Calculations for the Indicator | Median Wait times (in Days) from diagnosis to first treatment for patients with cervical cancer diagnosed in Calendar Years 2014 and 2015, and followed by receiving radiation therapy (with radical intent) in Ontario. Note that treatment date could take place after year 2015. Initial selection of the cohort in Ontario Cancer Registry (OCR) was extracted by the OCR data team. The date of first treatment for the same patients whoever were diagnosed in calendar years 2014 and 2015 would be used for diagnosis to treatment wait time calculation. Wait times (in days) calculation from diagnosis to referral, from referral to consult, from consult to treatment, and diagnosis to treatment were calculated by: | Wait time Type | Formula | | Diagnosis to Referral | Referral Date – Diagnosis Date | | Referral to Consult | Consult Date – Referral Date | | Consult to Treatment | Consult Date – First treatment Date | Regional and Ontario Median wait times (in days) for each year will then be calculated. | | Standardized Rate Calculation | N/A | | Unit | Median Wait Time (in days) | | Data Sources | Cancer Care Ontario, Ontario Cancer Registry (OCR) and Activity Level Reporting (ALR) | | Time Frame | Calendar Years 2014 and 2015 | | Geographic Scale | Regional cancer program | | Denominator Description | N/A | | Numerator Description | N/A | | Considerations | - Any patients with cervical cancer diagnosed during calendar years 2014 and 2015 and identified in OCR are included;
- Cases with valid diagnosis dates and treat dates (Radical Intent) are considered as valid cases for the wait time calculation.
- Cervical cancer cases with radiation therapy in ALR are extracted based on the selected clinical practice group code (Cervix Uteri)
- Not all Regional Cancer Centers treat Cervical cancer
- Patients who had both single primary and multiple primary cancer are included.
| | Data Availability & Limitations | Consult to ready to treat and ready to treat to treatment intervals were collapsed due to data limitations. |
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