Quality improvement intervention to reduce time to postoperative radiation in head and neck free flap patients. Issue 11 (7th September 2021)

• Record Type: Journal Article
• Authors: Voora, Rohith S.; Stramiello, Joshua A.; Sumner, Whitney A.; Finegersh, Andrey; Mohammadzadeh, Amir; Fouania, John; Ramsey, Celia; Blumenfeld, Liza; Sacco, Assuntina G.; Mell, Loren K.; Califano, Joseph A.; Orosco, Ryan K.
• Is Part Of: Head & neck. Volume 43:Issue 11(2021)
• Page Start: 3530
• Page End: 3539
• Publication Date: 2021-09-07
• Subjects: free flap reconstruction -- head and neck cancer -- patient navigator -- postoperative radiation -- quality improvement; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26852
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Best‐practice guidelines for head and neck cancer patients advise postoperative radiation therapy (PORT) initiation within 6 weeks of surgery. We report our institutional experience improving timeliness of adjuvant radiation in free‐flap patients. Methods: Thirty‐nine patients met inclusion criteria in the 2017–2019 study period. We divided into "Early" ( n = 19) and "Late" ( n = 20) time‐period groups to compare performance over time. The primary endpoint was time to PORT initiation, with success defined as <6 weeks. Results: The number of patients achieving timely PORT improved from 10.5% in the Early group to 50.0% in the Late group ( p = 0.014). Patients undergoing concurrent adjuvant chemoradiation were more likely to meet the PORT target in the Late group ( p = 0.012). Conclusions: We ascribe this quality improvement in free‐flap patients to increased communication among multidisciplinary care teams, proactive consultation referrals, and a targeted patient‐navigator intervention. Though work is needed to further improve performance, insight gained from our experience may benefit other teams.