Care Pathways of Surgical Patients With Renal Cell Carcinoma (RCC) in Greek Public Hospitals

OBJECTIVES: Mapping the patients’ journey constitutes one of the most effective ways to determine patients' navigation problems in health services, including gaps and barriers that hinder their prompt access to care. The aim of this study was to map RCC surgical patients’ journey in the Greek health system, explore key stakeholders’ perceptions and identify best practices to streamline the patient journey process.

METHODS: An observational study design based on the Lean Thinking principles and a qualitative design with semi-structured interviews were used. Study population consisted of 24 patients and 8 healthcare staff members from a Greek public hospital’s surgical unit. Data was collected in 2023 in collaboration with hospital key stakeholders.

RESULTS: Regarding the pre-hospital journey, 25% of patients reported delays of over 3 months in contacting a PCP/GP after noticing that something was wrong. Additionally, 16.7% experienced long delays in getting diagnostic tests and referrals to specialists. System delays in starting treatment affected 25% of patients due to unavailability of specific surgeons, operating rooms, and ICU beds. For the in-hospital journey, the expected admission procedure time was 78.2 minutes. Longer waiting times were observed until the medical history recording and completing their admission papers (up to 39 minutes). Health care professionals identified the main challenges as a lack of nursing, medical, and administrative staff, and limited availability of operating rooms for RCC surgical patients.

CONCLUSIONS: Addressing the challenges in the provision of care to RCC surgical patients may require multidisciplinary efforts, including investments in healthcare infrastructure, staffing, and administrative processes to reduce delays, and enhance patient outcomes and quality of healthcare for RCC patients.