Time to Treatment and the “Golden Hour”: Why They Matter and How Clinical Pathways Can Help

The importance of rapid access to high-quality health care is a well-established principle in the fields of trauma, neurology, and cardiovascular med­icine. Given what we now understand about the frequency of cancer treatment delay and its ability to significantly diminish cancer survival, there is a strong ra­tionale for expanding the “golden hour” metaphor to include cancer care, with the goal of developing diagnosis-specific policies, procedures, benchmarks, regula­tions, and enforcement mechanisms that promote timely initiation of cancer care. As we have seen in trauma and other specialties, clinical pathways are a perfect medium for not only facilitating evidence-based cancer care but also setting re­quired, short-term, interval, time-driven goals that must first be met to achieve overall time to treatment initiation goals. Implementation of “golden hour”–fo­cused clinical pathways can be facilitated by digital health care management so­lutions that expand value-based health care by simultaneously improving health care quality (eg, fewer deaths, less morbidity, and more guideline-compliant care); lowering direct and indirect health care costs; reducing patient financial toxicity; and achieving greater patient, provider, and payer satisfaction.