Pathway map development as an approach to identifying priority areas for quality improvement in Ontario.

Abstract

108 Background: Disease Pathway Management (DPM) is the unifying approach to the way in which Cancer Care Ontario (CCO) sets priorities for cancer control, plans cancer services and improves the quality of care in Ontario. In 2014 DPM began developing a cervical cancer pathway map (CCPM) to map the patient journey along the cervical cancer care continuum. Objective: to report on the CPPM development process as a tool to identify key priorities for cervical cancer management in Ontario. Methods: DPM convened a multidisciplinary/multi-stakeholder cervical cancer working group with regional and specialty representation from across Ontario. Over 12 months, 33 individuals participated in an in-person meeting and monthly teleconferences. The CCPM was drafted using guidelines developed by CCO’s Program in Evidence Based Care (PEBC) and considering clinical guidance documents from several jurisdictions. Throughout the development process the team were asked to discuss and reach consensus on key priorities for improving care. Results: Twenty-two priority areas were identified across the continuum in: prevention, diagnosis, treatment, follow-up and survivorship. Opportunities were identified for: development/endorsement of evidence based guidelines; patient-centered approaches to screening; quality improvement; survivorship; drug funding implementation and a CPPM Knowledge Translation strategy. Potentially actionable items were aligned with relevant internal and external stakeholders including organized screening programs, the PEBC, provincial drug reimbursement programs and other quality improvement teams within CCO. Conclusions: The process of bringing multidisciplinary experts together in order to develop the CPPM successfully identified key priorities across the spectrum of care in Ontario and allowed identification of potential opportunities for quality improvement, development of practice guidelines and new models of care. In turn, the CCPM provides a patient-centred disease focused framework from which stakeholders can approach and evaluate new initiatives in the context of the cervical cancer continuum.