BACKGROUND
The impact of COVID-19 on elective surgery has been significant across Australia during both the initial disaster management phase and sustained social distancing changes. Head & neck cancer surgery has been a particularly challenging area due to both the risk to patients of surgical delays and the high-risk of patient-to-healthcare worker COVID-19 transmission.
The benefit of a robust multidisciplinary team (MDT) meeting in the management of head & neck cancer patients is well established. During the COVID-19 era, many of these meetings have “gone virtual”, with limited opportunity for direct patient assessment and contact. Our large tertiary hospital in Queensland noted an increase in day-of-surgery (DOS) cancellations for both surgical and anaesthetic concerns during this time. We sought to quantify and evaluate the impact of a “virtual” MDT on our ability to adequately plan and prepare our head & neck patients for surgery.
METHODOLOGY & RESULTS
Anonymised data was collected to identify & compare all patients who were presented through the Head & Neck MDT who went on to have DOS cancellations during the 6 months prior to the introduction of COVID-19 restrictions and the 6 months after the introduction of restrictions. Electronic records were reviewed to establish reason for cancellation and outcome. Results identified an increase in overall DOS cancellations, with final outcomes pending for some patients up to September 2020.
CONCLUSION
The virtual MDT has unsurprisingly impacted the quality of the pre-operative assessment of head & neck cancer patients and resulted in cancellations and changes to management plans. Although this was a largely unavoidable impact of COVID-19 on our healthcare system, we are able to learn from this to improve our approach to similar challenges in the future.