A Discharge Summary Prompt Reduces Postoperative Radiotherapy Delay in Head and Neck Cancer Patients

BACKGROUND: Delays in postoperative radiotherapy (PORT) beyond 6 weeks are associated with worse outcomes in head and neck cancer (HNC). This study evaluated whether a discharge summary prompt could reduce PORT delay. METHODS: A retrospective review of patients from 2018 to 2023 was used as a pre-intervention baseline. An EHR-based discharge summary intervention was implemented in May 2023. Delayed PORT was defined as initiation > 42 days from surgery. Time to PORT was evaluated with Kaplan-Meier and log-rank testing. Logistic regression identified predictors of delay; Cox modeling evaluated factors associated with time to PORT initiation. RESULTS: Among 391 patients (260 pre-intervention, 131 post-intervention), PORT delay decreased from 74.2% to 46.6% after implementation (p < 0.001). The discharge summary prompt was independently associated with lower odds of delay (OR 0.28, 95% CI 0.14-0.56; p < 0.001) and faster PORT initiation (HR 2.05, 95% CI 1.43-2.93; p < 0.001). CONCLUSIONS: A simple discharge summary prompt may reduce PORT delay in HNC.