• 2,500 women
    were determined to be at high risk for breast cancer by the High Risk Screening Program in Ontario in 2014
  • 84%
    of cancer patients saw a registered dietitian at a regional cancer centre within 14 days of referral in 2015
  • 72%
    of stage III colon cancer patients received chemotherapy within 60 days after surgery
  • 84%
    of all cancer surgery patients received their consult within the recommended wait time in 2015, and 88% received their surgery within the recommend wait time
  • 29%
    of patients with oropharynx cancer and 20% with cervical cancer visited the emergency department while undergoing a course of curative radiation therapy between 2012 and 2015
  • 44%
    of breast cancer patients, 48% of colon cancer patients and 62% of lymphoma patients visited the emergency department or were admitted to hospital at least once while receiving chemotherapy
  • About 25%
    of patients who undergo lung, prostate and colorectal surgery have an unplanned hospital visit following cancer surgery
  • 64%
    of cancer patients had a first consult with an outpatient palliative care team within 14 days of referral in 2015
  • 40%
    of cancer patients visited the emergency department in the last 2 weeks of life in 2012
  • 361,991
    unique patients were screened for symptom severity using ESAS in 2015, representing 60% of patients
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Turnaround Times for Pathology

 
Measure Desired Direction As of this Report
Percent of cancer resection reports of all disease sites received by Cancer Care Ontario within 14 calendar days from date of surgery Black Arrow Up Green Arrow Null
See Methodology and Approach to find out how the ratings are calculated.

Key findings

In 2015, 82% of pathology resection reports were received on or before 14 days, which is close to Cancer Care Ontario’s target of 85%. There is, however, regional variation that ranges from 63% to 97%, as well as monthly variation that ranges from 76% to 87%.

What is pathology?

  • Pathology is the medical specialty that examines tissues and cells under a microscope to diagnose the type and severity of disease.
  • Almost all cancer patients begin their involvement with the cancer system through a series of diagnostic tests. Some of these tests involve removing tissue or cells so they can be examined.
  • Since cancer treatment decisions are based on the pathology diagnosis, the quality of pathology reports is extremely important. A misdiagnosis can result in incorrect, unnecessary, or harmful treatment.

What is synoptic pathology reporting?

  • Synoptic pathology reporting refers to a standardized electronic report in a discrete data field format (i.e. each type of information has a specific place and format in the report). It is meant to improve the quality and reliability of pathology reports. In Ontario, synoptic cancer pathology reports are standardized according to the College of American Pathologists cancer protocols and the electronic Cancer Checklists (eCC) standard, an internationally-accepted best practice for pathology reporting.

What is turnaround time for pathology?

  • Turnaround time is measured by the percentage of synoptic resection reports signed off by pathologists within 14 calendar days of the date of surgery.
  • Cancer Care Ontario receives pathology reports in real time (majority) or near to real-time (daily batch). This means that when it is received by Cancer Care Ontario it is also ready for clinicians. Pathology reports are used for treatment planning.
  • Patients, clinicians and pathologists have identified turnaround time as a key element in the evaluation of quality in surgical pathology1.
  • The pathology reports from more than 60,000 new cancer patients each year are sent electronically to Cancer Care Ontario from 116 acute-care hospitals and more than 400 pathologists. Several factors affect turnaround time, including specimen volume, pathology laboratory operations and the number of pathologists and support staff1.
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What do the results show?

Eighty-two percent (82%) of cancer resection reports were completed within the 14-day target in Ontario, but regional and seasonal variation exists (Figures 1 and 2).

  • At the provincial level, 82% of resection reports were completed within the 14-day target seen in Figure 2.
  • When looking at the percentage of reports completed within target by month, there is variation with the lowest rate (76%) in February and the highest (87%) in January (Figure 1).
  • Figure 2 highlights that regional variation was greater than seasonal variation, with Waterloo Wellington having only 63% of resection reports completed within the 14-day target, compared to 97% in Erie St. Clair.

Why is this important to patient care?

Timeliness is an important component of quality and positive patient outcomes.

  • Pathology diagnosis is the cornerstone to determine patient treatment and outcome.
  • Accuracy, timeliness, usability and completeness are the hallmarks of quality pathology.
  • A focus on timeliness will ensure that pathologists have the resources needed to complete reports in a timely manner.
  • Cancer Care Ontario has measured wait times in cancer surgery, radiation and systemic treatment for almost a decade, leading to increased resourcing and improved efficiencies. This, in turn, has resulted in more timely treatment.
  • Cancer Care Ontario has emphasized the importance of measuring wait times in relation to the entire patient journey. Pathologic assessment of cancer specimens is a critical component of the journey, and measuring pathology turnaround time aligns with that goal.
  • The surgical pathology turnaround time was introduced as a performance management measure in April 2013. As of April 2014, surgical pathology turnaround time encompasses all disease sites that are reported in synoptic format. This change allows hospitals and regions to better understand, highlight and address system and resource gaps.

Find out more

  • More information about Cancer Care Ontario’s Pathology and Laboratory Medicine Program is available on their website.

View Notes

  1. Zarbo RJ, Gephardt GN, Howanitz PJ. Intralaboratory timeliness of surgical pathology reports: results of two College of American Pathologists q-probes studies of biopsies and complex specimens. Arch Pathol Lab Med. 2000; 120:234–44.