Table 5 Cancer care concerns and suggested solutions
From: Challenges in multidisciplinary cancer care among general surgeons in Canada
Concerns (n, % respondents) | Issues (n respondents) | Suggested solutions (n respondents) |
|---|---|---|
Barriers to diagnosing and staging cancer (82, 30.6) | CT/MRI/ERUS (22) Endoscopy (21) Core biopsy/breast imaging (19) Access to/timely radiology (17) Referral by family physicians (3) | Funding for more resources (33) Establish and monitor benchmarks (6) Prioritize cancer cases (5) Centralized workup facility (4) Improved coordination (3) Patient education (1) Privatize (1) Colorectal cancer screening program (1) |
Lack of operative resources (67, 25.0) | OR time (53) Lack of surgical beds (5) Nuclear medicine/equipment for SLNB (4) Anesthesia shortage (2) Lack of nurses (1) Old laparoscopic equipment (1) Surgery assistants (1) | Funding for more resources (24) Prioritize cancer cases (11) Lobby/increase public awareness (2) Weekend operating time (1) Privatize (1) Create non-hospital surgical centres (1) Clinical model (refer to group) (1) |
Barriers to coordinating multidisciplinary care (55, 20.0) | Coordination of care (23) Referral to specialists (16) Proximity to cancer specialists (6) Challenge of participating in tumor boards (6) Patient retention at large centres (2) Challenges of organizing clinical trials (2) | Regional integration/coordination services (7) Funding for more specialists (5) Oncology electronic medical record (5) Communication to referring offices (5) Radiation oncologist visits satellite clinic (3) Open new radiation facilities (3) Organized implementation tumor boards (3) List of available specialists (2) Patient-centred care pathway (1) |
Lack of data to guide care delivery (20, 7.5) | Lack of/applicability of evidence (19) Timely performance measurement (1) | Patient-specific guidelines (4) Funding for more resources (3) Tumor boards (2) Develop cancer-specific programs (2) |
Access to pathology (15, 5.6) | Delayed pathology (15) | Funding for more resources (8) Establish and monitor benchmarks (1) |
Need for patient support resources (12, 4.5) | Navigation (5) Information (5) Shared decision making tools (2) | Funding for the development of information resources (5) |
Heavy workload (10, 3.7) | Overwhelmed (9) Patients with no family physician (1) | Nurse practitioners/GP oncologists (5) Funding for more surgeons (4) Prioritize cancer patient access to family physicians (1) |
Need for opportunities to develop skills (7, 2.6) | Training for practicing surgeons (7) | Increase mentorship opportunities (3) |