Basil Yannoulias
University of Birmingham, United KingdomTitle: Fast-track’ pathway for resectable pancreatic cancer: barriers and facilitators to implementation across a regional network
Abstract
Introduction
The National Institute for Health and Care Excellence guidelines recommend a ‘fast-track’ approach to avoid preoperative biliary drainage (PBD) when treating resectable pancreatic cancer. For reasons not yet known, there is variable uptake of this approach across the UK. A ‘fast-track’ pathway which avoids PBD was introduced in University Hospitals Birmingham NHS Foundation Trust (UHB) and referring centres in 2015.
Methodology
Eleven semi-structured interviews were conducted with members of the hepatobiliary multidisciplinary team (MDT) in UHB and referring centres. Barriers and facilitators to pathway implementation were assessed.
Results
Facilitators underpinning implementation were collaboration between stakeholders, clinical leadership and careful coordination of referrals. Barriers to implementation included clinician opposition and increased workload. Barriers were mitigated through phased implementation and the appointment of dedicated staff.
Conclusion
Future work may focus on exploring contextual factors in other tertiary centres and evaluating the emotional impact of ‘fast-tracked’ versus delayed surgery in patients with resectable pancreatic cancer.
Biography
Basil Yannoulias is a medical doctor currently based in the West Midlands, United Kingdom, undergoing rotations in trauma and orthopaedic surgery, paediatrics, general surgery and cardiology. Prior to qualifying in medicine at the University of Birmingham in 2021, Basil graduated with a degree in health management at the Health Services Management Centre at the University of Birmingham with first class honours. During this degree he undertook research in the implementation of fast-track surgical services which has been published in the Future Healthcare Journal. He is actively involved in research and aspires to combine a clinical career with academic and leadership pursuits.
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