Purpose
An audit was undertaken to evaluate the treatment and care pathways for colon and rectal cancer patients in Gippsland, benchmarking local practices against the Optimal Care Pathways for colorectal cancer. It aimed to identify any variations in care, delays in diagnosis and treatment timelines, and areas for improvement. Data from Bairnsdale, Central Gippsland, Latrobe Regional, and West Gippsland Health Services were analysed to inform targeted service improvement.
Sample
The audit focused on patients diagnosed with colon or rectal cancer between 2018 and 2023, excluding those treated outside Gippsland. A total of 96 patients were included: 77 with colon cancer and 19 with rectal cancer, identified using ICD-10 codes and relevant surgical procedures.
Procedures
An audit tool was developed, and support from local general surgeons was established. Medical records were reviewed and data entered into REDCap. Findings were analysed and presented with recommendations for improvement initiatives.
Results
The audit identified key gaps in care, particularly inconsistent referral documentation and delays to diagnosis and treatment. Only 20% of rectal and 42% of colon patients underwent endoscopy within recommended timeframes. While 79% had investigations within two weeks of diagnosis, 42% of colon and 80% of rectal cancer patients experienced treatment delays. Only 21% of colon cancer patients were diagnosed at stage 1, with late-stage cases presenting via emergency.
Conclusion and clinical implications
This audit represents the first phase of a broader, multi-pronged quality improvement initiative aimed at strengthening care across Gippsland. Key areas for improvement include delays in diagnostic pathways, gaps in post-surgical care, and referral documentation inconsistencies. Activities include implementing e-referral systems and a colonoscopy waitlist dashboard to improve transparency and timeliness; and integrating prehabilitation and ERAS protocols to reduce complications and support faster recovery. Collectively, these efforts aim to align regional care with statewide standards and reduce unwarranted variations.