The COVID-19 pandemic has changed the way cancer patients should be managed. Using published literature on best practices on oncology patient management, we developed checklists to establish which recommendations were followed and differences between healthcare staff and institutions in a local health unit (overseeing two regional hospitals and 14 primary Healthcare Centers) in an interior region in Portugal. Checklists were delivered and completed by 15 physicians, 18 nurses and 5 pharmacists working at the Hospitals, and 29 physicians and 46 nurses from primary healthcare centers. Hospital staff do not show statistically significant differences regarding most proposed recommendations for the oncology clinical pathway, human resources, treatments, patient management and service management. Primary healthcare centers seem to follow a similar trend. As a local health unit, general recommendations for Oncology Patient Management show statistically significantly different values on education of suspected cases, identification, isolation procedures and samples collection; extension of work schedules; and education on cancer patient and COVID-19 positive referral procedures. All the checklists indicated good-to-high internal consistency. Our analysis showed cohesive work between groups regarding control and prevention of sources of infection; therefore, it is considered the highest priority to ensure that all other services, including oncology, continue functioning. Patient management measures such as adjustments in treatments, analysis, patient care, referrals and emergencies were not ranked higher by responders.

Background Quality oncological care demands the joint effort from different healthcare professionals; therefore, Clinical Pathways could benefit a well-defined group of patients using organized interventions to standardize and increase care processes efficiency. The objective is to develop an integrated patient centered care based on evidence guidelines, patients feedback and best practices to facilitate communication and coordination between the multidisciplinary teams. Official health entities should have tools to identify their oncological clinical pathways for a better institutional organization while aiming to reduce mortality rates and contain costs without compromising the quality. Methods With the use of specifically designed questionnaires, we intended to identify a physical oncology clinical pathway. By determining the tumor staging at service arrival; time intervals on tumor suspicion/diagnosis confirmation and diagnosis/first treatment; referral pathway; diagnostic networks and patient Follow-up from a sample of nurses and physicians in a regional health unit, overseeing two regional hospitals (RHs) and 14 primary healthcare centers (PHCs) in a rural interior region in Portugal, we were able to determine and identify the oncology clinical pathway available to cancer patients in the region. Results Our findings point to different appreciations of tumor staging at arrival in PHCs and RHs (the latter receiving more metastatic cases); consensus of approximately 4 weeks between tumor suspicion-diagnostic and divided opinions regarding diagnostic-treatment time interval. Moreover, PHCs depend on private laboratories for their diagnostics confirmation, contrarily to the RHs which are resolved locally. Referral pathways indicate almost half of the patients being sent from primary healthcare centers to National Reference Hospitals instead of being treated at a Regional Hospital. Patient follow-up is carried out throughout the local health unit, however, is more developed at RHs. As patients advance through the clinical pathway and approach their treatment stages the number of healthcare professionals reduce leaving mostly Hospital staff involved in this phase and healthcare centers staff primarily involved in diagnostic stages. Conclusion Our questionnaires helped gain insight on the clinical pathway to not only illustrate it but also analyze important sections, strength of association between its parts and points of entry for patients into the healthcare system.