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April 28, 2009
Results of Ontario’s 2009 Cancer System Quality Index
(CSQI) show that key cancer services in Northwestern Ontario
are accessible, timely and safe, while additional effort is
needed for certain cancer screening and prevention strategies.
Overall, the CSQI shows Regional Cancer Care – Northwest
as one of the top performers in Ontario with respect to chemotherapy,
radiation therapy, and cancer surgery wait times. The program
also scored high marks in following provincial standards and
best practice to ensure the safety and quality of cancer services
for patients. For example, Regional Cancer Care was recently
congratulated as the first cancer program in Ontario to implement
OPIS 2005 across the entire LHIN. A Computerized Physician
Order Entry system, OPIS 2005 allows clinicians to electronically
order and monitor chemotherapy treatments for patients across
the region, enhancing accuracy and patient safety.
However, the area of colorectal cancer screening requires
additional work, particularly in reducing wait times for colonoscopies
as demand continues to grow. According to the CSQI, 90 per
cent of people in Northwestern Ontario who had a positive
Fecal Occult Blood Test (FOBT) for colorectal cancer are waiting
33.7 weeks for a follow-up colonoscopy. The provincial average
is 23.3 weeks.
“The launch of the provincial colorectal screening
program, ColonCancerCheck, was revolutionary for the cancer
system. We, like many other centres, are in the process of
making the necessary changes to accommodate an increase in
colonoscopies resulting from positive FOBT. The current wait
times are not ideal, but they are an improvement from year-long
waits that we have seen in the recent past. We are taking
steps to improve our processes, and are confident wait times
will go down as the system adjusts,” said Michael Power,
Vice President of Regional Cancer and Diagnostic Services,
Thunder Bay Regional Health Sciences Centre (TBRHSC).
Part of the issue, Power said, is that surgeons and gastroenterologists
are working hard to screen a long list of patients who may
have entered the colonoscopy queue without first being screened
by FOBT, meaning they may have been able to avoid a colonoscopy
altogether.
“The ColonCancerCheck program is still young. We have
taken all the right steps – increased capacity and equipment
to perform 1,150 colonoscopies each year in Thunder Bay, Dryden,
Kenora, Sioux Lookout and Fort Frances, and recently started
a monthly colonoscopy clinic in Marathon to provide the services
closer to home for residents of the North Shore. Through the
leadership of Dr. Gabriel Mapeso, Gastroenterologist and Dr.
Heather McLean, Primary Care Physician Lead, our clinical
team will work to steadily reduce these wait times in the
months ahead,” Power said.
The CSQI also held a mixed review of Cancer Prevention in
Northwestern Ontario, which continues to have some of the
highest rates of obesity, inactivity, smoking and alcohol
use in Ontario. On the positive side, adults in Northwestern
Ontario seem to be losing weight, eating a few more vegetables
and fruits, and consuming less alcohol compared to last year’s
report. However, smoking rates continue to rise.
“The improvements shown in rates of obesity, alcohol
use and vegetable and fruit intake may seem small, but they
are actually quite significant. It tells us that people are
making different, healthier choices. However, there is still
much work to do in cancer prevention, especially with respect
to smoking rates,” said Alison McMullen, Director of
Prevention and Screening, Regional Cancer Care.
The first of its kind in North America, the CSQI tracks Ontario’s
progress against cancer. It shows where quality and performance
improvements are needed and reports on 29 evidence-based quality
measures covering every aspect of cancer control, from cancer
prevention to end-of-life care.
For more information visit the CSQI
website or Cancer
Care Ontario.
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