Patient Pre Clinic Expectations of a Visit to Ontario’s Only Multidisciplinary Skin Cancer Clinic

Purpose/Aim: The Odette cancer centre runs a weekly multidisciplinary skin cancer clinic for patients diagnosed with non melanoma skin cancer. The clinic sees upward of 14 new patients and 14 follow up patients each week. The patients see 5 different clinicians each visit. They see a Pathologist, Dermatologist, Plastic Surgeon, Radiation Oncologist and a Clinical Specialist Radiation Therapist (CSRT). The majority of the patients are referred from outside dermatologists. We inform the outside clinics of the multidisciplinary nature of our clinic and the expected time a patient’s appointment may take. However we were noticing many upset patients, due to the wait time for their appointment, the time they spend in the clinic rooms being seen by the various practitioners and a general misunderstanding of why they were at this clinic. Method/Process: We decided to simply ask our patients 4 simple questions while we were doing their history and physical exam. We asked 20 patients: 1. What do you think you are here for today? 2. What did your referring dermatologist tell you about this clinic? 3. Are you aware you will be seeing several doctors today? 4. How much time have you allowed for your visit today? Anecdotal results from 20 patients: Correct answer, Wrong answer, Partial answer QUESTION 1: 8, 9, 3 QUESTION 2: 4, 14,2 QUESTION 3: 3, 16, 1 QUESTION 4: 12, 8, From here we decided to formalize our questions and give our patients a questionnaire with the same questions on it to allow them time to think about their responses. We gave these questionnaires to 35 patients in the next month. Results/Benefits/Challenges: RESULTS: From 35 patients: Correct answer, Wrong answer, Partial answer QUESTION 1: 16, 13, 6 QUESTION 2: 6, 22, 7 QUESTION 3: 6, 28, 1 QUESTION 4: 20, 11, 4. Conclusion/Impact/Outcomes: We saw that 63% of our patients were not receiving any information about our clinic from their referring dermatologists, which could account for some of their upset when they eventually get into the clinic room. Also 80% of the patients had no idea they would be seeing several physicians and more than 37% had no idea why they were even in a cancer center. These numbers were disturbing. We looked at ways to combat this, as educating the referring offices did not seem to be helping. We decided the skin site CSRT would call the patients a week before their appointment and give them the information they need. We will repeat the questionnaire with the expectation that the numbers will improve. We plan to re do the questionnaire once per year to ensure patients are receiving the information they require before they attend the clinic. We hope this will increase patient satisfaction and allay many of their fears.