Table 4 Improvement suggestions, response and planned actions

Case managers for (all) patients/all tumor types

A/ Agree

“This is important but requires specialized staff, currently shortage of this specialized staff.”

Currently there are official case managers for 5 tumor types, development of case managers for other tumor types will follow these examples

B/ Agree

“Case managers are an important tool in patient treatment so we want to improve this area.”

Already part of the strategic vision so no extra actions need to be taken

C/ Agree

“It would be good to have case manager-the process has to be more organized, more patient oriented.”

Educate the right staff and dedicate them as case-manager

F/ Agree

“A case manager for each pathway will be formally identified.”

Define clear role and responsibility for the case manager for each pathway/tumor type

Develop more support for survivors

B/ Agree

“With the increase of the survival rates in cancer patients we recognize that this is an area that we must improve.”

A website where survivors can exchange information and experiences was already launched.

A portal for survivors, amongst others, is under development.

D/ Agree

“Survivorship programs are provided mostly by the patient organizations.”

Develop own survivorship program for the institute and further formalize the collaboration with patient organizations in survivorship programs.

Increase patient participation in the care process

B/ Agree

“We are already working in this area.”

An area on the website is under development were patient can access: future appointments, exams results and requisitions, among other clinical and administrative information.

The portal that is under development will have one tab containing the patients targeted information.

Improve patient participation in the organization/strategy development

C/ Partially agree

“Patients have to be involved. However not all patients want to be involved.”

All patients have to pass the MDT. And after discussion-take a decision on whether to participate. This participation has to be organized.

Develop a structured, institute wide adverse events analysis system

C/ Agree

“It is absolutely necessary to check and register these events. Important for the quality of care.”

Depends on the staff. Sometimes they hide the information

Measure staff satisfaction

C/ Agree

“Staff has to be honest and not just provide the socially accepted answers.”

Regular discussions with staff, improve existing questionnaires

Central complication registry may be useful

A/ Partially agree

“Complication registration is mainly useful for healthcare professionals, current registration system allows health professionals to see the data important for them, per discipline. Central registration could be useful to annually analyze the results and look at the trends compared to trends in for example new patients. The national institute for Clinical Auditing registers complications as well on a national level.”

Create system that can extract data from existing system or develop new registration system

Implement Computerized Physician Order Entry

E/ Agree

Electronic prescriptions are currently being implemented: in the short term there will be 2 pilot actions for 2 departments. It is currently planned to include treatment details (chemotherapy data), transfusions and clinical trial participation.

F/ Partially agree

“This is an important and urgent objective, but unfortunately due to regional restrictions the institute cannot be proactively proceed. ”

Improve patient transition protocol

H/ Agree

“We should improve the network with other hospitals/institutes, care facilities and general practitioners (GPs) as well.”

Improvement of the electronic chart (e-chart): at regional level, the first attempt has been made within the region

Assess and improve inpatient bed utilization

H/ Partially agree

“Inpatient bed utilization is planned and regulated at regional level.”