Transcript Where are we going wrong? The story behind unneccessary

Where are we going wrong
• Journalists never tell what is oke (and many
things go well)  no sensation???is struggle
for life so sensational?
• Share responsibilites between government,
medical staff, patients and investers, but all
have different agenda’s!
If we
would
have
the available
used
If we had
had not
knowledge, this wouldn’t
communicated,
this would
happened!!
have happened
You never
listened to us
Patient’s journey:
Care givers involved: average 20 until 1st T
Patient’s journey
•
•
•
•
•
•
•
Question of organisation: logistics
Structure
Process
Planning
Responsabilities
Possibilities
Competence
Cancer care
• Cost oriented
– Efficiency
– Efficacy
– >Cost- effectiveness
• Outcome oriented
– Medical :
• Survival
• 30 days mortality after surgery
• Patient oriented
– Quality of life
Elements of a quality system for care
research
professionals
organization
audit
patients
education
Levels of measures and
influences
European/international
National
Control
signals
and actions
Regional
Local
individual
Information
Patient’s journey
• Very complex
• Many players
• Different focusses and definitions concerning
what is right
Number of available indicators by
country for population based CRs
N=13 of 86
Indicators: stage; delay of 1st treatment; compliance to guidelines
Where are we going « wrong »?
• Patient does not know where to go
• No information available on which teams in
which hospitals are good in which kind of
cancer
• BUT: what is good??
• How to get access to the dedicated
teams?(health care system)
Where are we going « wrong »?
• Cancer requests a multidisciplinary approach between
at least 5 different disciplines:
–
–
–
–
–
Radiologist
Pathologist
Surgeon
Radiotherapist
Medical oncologist
• How do they work toghether? Who is responsible for
what? How is the communication between them as
the patient will be informed by at least 3 different
specialists!!! How is paid for what!