AB116. SOH23ABS_029. Streamlining skin cancer care: the application of lean principles to the non-melanoma skin cancer pathway
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AB116. SOH23ABS_029. Streamlining skin cancer care: the application of lean principles to the non-melanoma skin cancer pathway

Muireann Keating1, Stephanie Bollard1, Kelsey O’Donnell2, Shirley Potte2, Fergal Moloney2, Alan Coleman3

1Department of Plastic and Reconstructive Surgery, Mater Miscericordiae University Hospital, Dublin, Ireland; 2Department of Dermatology, Mater Miscericordiae University Hospital, Dublin, Ireland; 3Transformation Officel, Mater Miscericordiae University Hospital, Dublin, Ireland

Background: Non-melanoma skin cancer (NMSC) is the most common malignancy diagnosed in Ireland, with over 10,000 cases diagnosed nationally per year. A ‘See and Treat’ model in NMSC offers a patient being reviewed by a Consultant and operated on the same day if suitable. The introduction of a ‘See and Treat’ model using Lean Principles improves patient flow, by reducing wait times, improving patient satisfaction and reducing overall staff cost.

Methods: Patients in ‘See and Treat’ pathway are referred directly to the minor operating theatre or surgical day unit. Here they are assessed by a consultant, and if appropriate undergo an immediate surgical procedure. Resources needed for successful See and Treat service includes standardised GP referrals with photographs, appropriate patient information and consultant availability.

Results: The model used in our Department reduces the waiting times from referral to excision from 134 to 61 days in total, with no adverse impact on excision rates. A Time-derived Activity Based Costing Analysis was performed, with the staff identified in the current NMSC pathway. The See & Treat model implemented saves €11,500 per 100 patients in staffing and administration costs. Applying this analysis to the Plastic Surgery waitlist figures from NTPF, we estimate healthcare savings of €1.7 million.

Conclusions: In keeping with the Lean Principles, the implementation of ‘See and Treat’ model for the management of NMSC improves overall process flow. It reduces waiting times, improves outpatient availability and reduces staff costs.

Keywords: Cost; lean principles; non-melanoma skin cancer (NMSC); plastic surgery; skin cancer

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-23-ab116
Cite this abstract as: Keating M, Bollard S, O’Donnell K, Potte S, Moloney F, Coleman A. AB116. SOH23ABS_029. Streamlining skin cancer care: the application of lean principles to the non-melanoma skin cancer pathway. Mesentery Peritoneum 2023;7:AB116.

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