The organizational Model of the Oncology Network: Clinical Governance, Process Innovation, Lean Management

Abstract

INTRODUCTION
The use of diagnostic therapeutic assistance pathways (PDTA) and patient management through Multidisciplinary Oncology Business Teams are recognized as effective tools to deal with the complexity of managing cancer patients. The multidisciplinary approach ensures greater timeliness of decisions, improves timing and coordination, contributing to the control of the risks of medical error and inappropriateness. The Team is a coordinated group of healthcare professionals from different disciplines involved in the treatment of a specific pathology, which aims to improve patient care.
GOALS
The objectives of the proposal are to create an Organizational Model of operation of the ASL BT Oncology Network capable of guaranteeing that all appropriate diagnostic tests and treatment options are considered and evaluated for each oncology patient discussed within the Team, taking into account account of the patient's values and the pursuit of a policy of improving the quality of care, the path and health outcomes. Furthermore, contribute to the drafting and continuous updating of PDTAs, the creation of links with other healthcare organizations to ensure appropriate referrals, timely consultations and optimize the continuity of patient care and to innovation, research and participation in clinical trials .
METHODS
The proposed model aims to achieve the objectives explained through the identification of targeted actions by the Team Leader and the Multidisciplinary Teams aimed at taking care of the patient on multiple fronts, from the purely medical-diagnostic to the human and psychological one, guaranteeing him a better diagnosis and treatment path.
RESULTS
9 Multidisciplinary Oncology Teams per pathology; 9 Team Leaders and 9 Case Managers; 9 Diagnostic-Therapeutic-Assistive Paths, 7 of which implement regional guidelines and 2 which introduce new technical proposals on specific districts (Head-neck and Neuro oncology) as the leader in the Puglia Region; 1 Multidisciplinary Team dedicated to cervicofacial tumors with an opening to a broader plan for the creation of one of the few Head and Neck Departments in Southern Italy; Single Multidisciplinary Report format drawn up by each Multidisciplinary Team; Standardized PDTA model drawn up according to the certification criteria, homogeneous for all pathology-specific paths; Implementation of nutritional and psychological support; Evaluation of perceived quality (PREMS/PROMS) by the patient with a reporting system followed by audits by the Team and proposed corrective actions.
CONCLUSION
An organizational model of Clinical Governance and Management of Clinical Organizational Processes which forms the basis of an Accreditation Manual, experimentally applied to the Oncology Network theme, with the following founding elements: Accreditation and standards of excellence; Telemedicine, Communication and empowerment of patients, caregivers and associations, Multidisciplinary management, Second opinion, Resource optimization with sharing of innovative specialist figures, Ultra-specialist professional training, Management of waiting lists and fast consultation path. It is a strategic organizational model: "from research to health management", innovative, which allows us to respond to health needs in the oncology field.