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A meeting of the minds
Nova Scotia’s first consensus meeting on thyroid cancer

Earlier this summer 35 health professionals – surgeons, radiologists, pathologists, nurses, and others – from across the province came together with one goal: to improve the quality of thyroid cancer care in Nova Scotia.

Participants at the consensus meeting, coordinated by Cancer CMRare Nova Scotia, were exploring how guidelines released last year by the American Thyroid Association could be adapted for use here in Nova Scotia. “These guidelines provide consistent, up-to-date information at a high level. We wanted to take this broad view and determine how best practices can be applied here in our province,” notes Dr. Murali Rajaraman, Co-chair of the Thyroid Cancer Care Multidisciplinary Team.

Having uniform guidelines in place enhances consistency and communication – and much more, says Dr. Rajaraman. “They help reduce medical error, lower patient anxiety, and improve care through a single, reinforced path of treatment.”

One of the issues that was explored on June 11th, notes Ms. Jill Petrella, CCNS Quality Manager, was the benefit of using a standard template for reporting pathology findings. “Participants recommended that the College of American Pathologists’ form be used, and that it be available electronically. This will enable consistency in how pathologists report their findings.”

Now, she adds, radiologists in the province are also looking to develop their own template. Other recommendations included clinical indicators to be monitored for quality assurance and areas for additional education.

The consensus meeting is a new approach to exploring one type of cancer in depth, says Dr. Drew Bethune who, until recently, was Chair of CCNS’s Cancer Site Teams. Cancer Site Teams are responsible for standards and guideline development. “As a result of this consensus meeting,” he says, “we will have an excellent set of guidelines will improve patient care.”

Patients are not the only people to benefit, notes Dr. Rajaraman. “We’re also enhancing our knowledge base as professionals.”

The meeting, he stresses, was truly a group effort. “Unless you have a willing and able team you aren’t going to get very far in the development of standards. Everyone worked together.”

Dr. Sandy McEwan, Chair of the Department of Oncology at the Cross Cancer Institute in Edmonton served as content expert and facilitator for the day. The group investigated nine key questions related to thyroid cancer diagnosis, care and treatment to reach consensus on guidelines as to how patients will be treated.

Dr. Bethune says this uniform approach enables a database to be created that can be used for quality assurance and research – which, in turn, can be used to adjust the guidelines as necessary.

In addition to the database, Nova Scotia-specific guidelines are being prepared for health care providers, notes Ms. Petrella.

“Although the consensus meeting focused on thyroid cancer, the process can be used to advance care in other areas such as bowel and breast cancer, which are treated throughout the province,” says Ms. Petrella.

Next steps will include circulating the draft consensus statements and the draft Nova Scotia guideline to a broader audience for review and working with pathologists and radiologists from across the province on finalizing the templates and putting them into practice.

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