It is proposed that patients with non-melanoma head and neck cancers, likely to need minor surgery with a low perioperative risk, can have the time spent waiting for surgery and the number of appointments attending the hospital reduced.
The simplified pathway to treatment is in three steps:
- First pass screening of referrals (when the referral is received): Completed by a clinician using defined criteria to identify eligible cases that are either inside or outside the defined criteria for the model Inside: patients with non-melanoma skin cancers of the head and neck Outside: non-skin cancer, anticoagulated patients, lesions on the lower limbs, cases where frozen section control or special equipment available only in the main operating theatres is necessary, patients unable to consent
- Second pass screening (before coming to hospital): Completed by a nurse in pre-admission clinic via telephony to educate patients about the model of care, the need to present fasting, and to administer an anaesthetic questionnaire to determine perioperative risk;
- Clinical assessment and treatment (day of surgery): Patients are assessed by a consultant plastic surgeon who makes a surgical plan and completes the consent process with the patient; this is followed by anaesthetic assessment and then surgical treatment (with anaesthetic support as required) in a nearby adjacent operating theatre, followed by recovery and discharge on the same day.
Skin Lesion Assessment Management (SLAM) is an initiative between the Division of Surgery, the Department of Plastic and Reconstructive Surgery, the Department of Anaesthesia and the Day Surgery Treatment Unit at the Princess Alexandra Hospital.