Professional delays in referral of patients with mouth cancer: six case histories

Daniel, M. T.; Rogers, Simon

doi:10.1038/s41415-022-5304-5

Cited by 6 publications

(2 citation statements)

References 7 publications

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“…33 Lack of primary care access delays specialty referrals, 67 while limited HCW knowledge of HNC signs can lead to misdiagnosis and care delays. 68 Even after specialty referrals, 25% to 50% of referring HCWs are unaware of whether the patient sees a specialist, 44,45 and approximately 45% of referrals involve no communication from specialists, 46,47 underscoring the critical role of interclinician and patient-HCW communication highlighted in our study. These communication gaps complicate the transfer of patient information between institutions, which also leads to delays.…”

Section: Discussionmentioning

confidence: 74%

“…The findings of our study align with those of existing literature, and highlight the complexity of the HNC referral pathway, which involves referring HCWs, specialists, and patients . Lack of primary care access delays specialty referrals, while limited HCW knowledge of HNC signs can lead to misdiagnosis and care delays . Even after specialty referrals, 25% to 50% of referring HCWs are unaware of whether the patient sees a specialist, and approximately 45% of referrals involve no communication from specialists, underscoring the critical role of interclinician and patient-HCW communication highlighted in our study.…”

Section: Discussionmentioning

confidence: 96%

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Perspectives on Referral Pathways for Timely Head and Neck Cancer Care

Batool,

Hansen,

Sethi

et al. 2024

JAMA Otolaryngol Head Neck Surg

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ImportanceTimely diagnosis and treatment are of paramount importance for patients with head and neck cancer (HNC) because delays are associated with reduced survival rates and increased recurrence risk. Prompt referral to HNC specialists is crucial for the timeliness of care, yet the factors that affect the referral and triage pathway remain relatively unexplored. Therefore, to identify barriers and facilitators of timely care, it is important to understand the complex journey that patients undertake from the onset of HNC symptoms to referral for diagnosis and treatment.ObjectiveTo investigate the referral and triage process for patients with HNC and identify barriers to and facilitators of care from the perspectives of patients and health care workers.Design, Participants, and SettingThis was a qualitative study using semistructured interviews of patients with HNC and health care workers who care for them. Participants were recruited from June 2022 to July 2023 from HNC clinics at 2 tertiary care academic medical centers in Boston, Massachusetts. Data were analyzed from July 2022 to December 2023.Main Outcomes and MeasuresThemes identified from the perspectives of both patients and health care workers on factors that hinder or facilitate the HNC referral and triage process.ResultsIn total, 72 participants were interviewed including 42 patients with HNC (median [range] age, 60.5 [19.0-81.0] years; 27 [64%] females) and 30 health care workers (median [range] age, 38.5 [20.0-68.0] years; 23 [77%] females). Using thematic analysis, 4 major themes were identified: the HNC referral and triage pathway is fragmented; primary and dental care are critical for timely referrals; efficient interclinician coordination expedites care; and consistent patient−practitioner engagement alleviates patient fear.Conclusions and RelevanceThese findings describe the complex HNC referral and triage pathway, emphasizing the critical role of initial symptom recognition, primary and dental care, patient information flow, and interclinician and patient−practitioner communication, all of which facilitate prompt HNC referrals.

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