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 had used the available

knowledge, this wouldn’t had happened!! You never

listened to us

If we would have communicated, this

would not have happened

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

professionals organization

patientsaudit

education

research

Levels of measures and influences

National

Regional

Localindividual

Information Control signals

and actions

European/international

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!