Royal College of Surgeons in Ireland
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Improving a referral pathway to an acute head and neck oncology surgical clinic

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posted on 2023-10-17, 07:29 authored by Heather Ryan

In 2007, the organisation where this Quality Improvement project took place, was officially designated as a Centre of Excellence for Head and Neck Cancer Services. As a result, the Head and Neck Oncology Clinic and Surgical Department within the organisation receives high volumes of referrals. The data analysed for this study included 22 patients (n=22) who attended the Head and Neck Oncology Clinic between November to December 2021. Of this cohort of patients, the data revealed that over 50% of the referrals failed to document the fundamental referral criteria as stipulated by the National Cancer Control Programme for a suspected head and neck malignancy. This affected the assessment of the patient’s clinical status prior to attending the clinic. On examination of the referral forms, it was evident that there was insufficient detail to determine if the referrals received were deemed as urgent or routine. Secondly, the data exposed that 64% of the included sample (n=14) were waiting more than two weeks for their initial appointment to the clinic. The quality improvement therefore recommended was to enhance the quality of the referrals received through the creation of a custom-based referral form. The Lean Six Sigma Model with the DMAIC framework was utilised, along with additional quality improvement tools to aid in the completion of this project and proposed improvement plan for the organisation.


First Supervisor

Dr. Pauline Joyce


A thesis submitted in part fulfilment of the degree of MSc in Physician Associate Studies, RCSI University of Medicine and Health Sciences, 2023

Published Citation

Ryan H,. Improving a Referral Pathway to an Acute Head and Neck Oncology Surgical Clinic [MSc Thesis]. Dublin: Royal College of Surgeons in Ireland; 2023

Degree Name

  • MSc Physician Associate Studies

Date of award



  • MSc Physician Associate Studies

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