Timely access for care in cervical cancer: Improving treatment completion rates through enhanced multidisciplinary navigation.

267 Background: Timely initiation and completion of definitive chemoradiation, including brachytherapy, is critical for optimizing survival and local control in cervical cancer patients. Delays beyond a 56-day package time worsen outcomes (~1% survival loss/day). Institutional 56-day completion rates vary, averaging ~50%. Despite individual efforts, our own institutional rates remained largely stagnant for three years prior, highlighting systemic multi-specialty coordination challenges. Methods: We conducted a quality improvement project aimed to improve timely treatment for Stage I-IVA cervical cancer patients undergoing definitive chemoradiation. A dedicated navigation team in Radiation Medicine manually tracked each patient's complex treatment pathway across Radiation Oncology, Medical Oncology, Gynecologic Oncology, Diagnostic Radiology, Anesthesiology, and Operating/Procedure Room teams. Key functions included proactive identification and sequential scheduling of necessary appointment and procedures to maintain treatment timelines and prevent delays. Critically, patient status and clinical needs were continually monitored, with schedule adjustments and coordination of supportive services to mitigate delays and maintain timelines. Patient progress was tracked, and the primary outcome measure was the percentage of patients completing definitive treatment within 56 days of initiation. Results: We compared treatment completion package time pre-intervention (1/1/2021 - 12/31/2023) to post-navigation (1/1/2024 - current). Pre-intervention (N = 94): 61 (64.9%) completed ≤ 56 days; 16 (17%) completed between 57-63 days; and 17 (18%) at ≥ 64 days. Post-intervention (N = 38): 32 (84.2%) completed ≤ 56 days; 3 (8%) completed between 57-63 days; and 3 (8%) at ≥ 64 days. A Chi-square test comparing these periods showed statistically significant improvement in timely completion (p = 0.02763). Conclusions: This quality improvement project demonstrates that dedicated manual coordination significantly improves treatment timeliness for cervical cancer patients in complex multidisciplinary care. Care coordination and tracking provides a practical model for enhancing patient care. It can improve patient survival outcomes, reduce patient stress, and lessen health access disparities. It serves as a blueprint for potential development of future technology-based scaling solutions.