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29 Implementation of an oncology electronic referral system to improve access to care for children with cancer (IMPACT): a quality improvement initiative from a single center

Background Delayed access to cancer care has been associated with early childhood cancer death. Improving timely access to cancer care is the first important step in the cancer treatment journey. We implemented an electronic referral system (e-RS) at the Princess Noorah Oncology Center (PNOC) to improve timely access to cancer care. This study aimed to assess the impact of implementing an e-RS on timely access to cancer care. Methods This was an observational retrospective analytical cross-sectional study of 399 pediatric oncology patients selected through a consecutive non-probability sampling technique to review the turnaround time (TAT) of children with cancer diagnosed 12 months before (manual referral system) and 12 months after implementation of the e-RS. Results Of the 399 pediatric oncology patients diagnosed between January 2014 and December 2015, 59.91% were male and 40.09% were female, with a median age for both sexes of 5.0 years (IQR 2.5–9.0 years). 96.3% of the patients were Saudi and 3.7% were non-Saudi. The median processing time of the manual referral system was 1075 minutes (IQR 145–1498) while the median processing time for e-RS was 125 minutes (IQR 53–1013). By applying a Mann-Whitney test of significance, the TAT between the two systems was significant (p=0.0001). Conclusion Implementing an e-RS improved referral TAT. As a result, pediatric oncology patients had improved timely access to cancer care at PNOC based on TAT standards. The impact of this improvement on outcomes will be reported separately.