Establishing a multidisciplinary head and neck clinical pathway: An evaluation of implementation and outcomes

Ms Aoife O’reilly1, Ms Liv  Thompson-Williams, Ms Chelsea Marsh

1Capital & Coast District Health Board, Wellington, New Zealand

Background: A review was undertaken of the Allied Health service provision in the head and neck oncology space, prompted by observations of staff burnout due to volume of work and inadequacies within service model. Clinical service delivery was such that we were failing to meet Ministry of Health Standards for Service Provision for Head and Neck Cancer (HNC).

Aim: The aim was to establish an integrated HNC pathway for SLT and Dietetics with a focus on prevention and avoiding complications of treatment, thus positively impact on hospitalisation. Our aim was to reduce hospital admissions in this cohort by 10%.

Method: A literature review was conducted to establish best practice standards internationally. A stock take was completed of the service looking to identify waste in the system, opportunities for interdisciplinary practice, and to recommend a new model of care. Admission data was collected monthly and reviewed.

Results: Over a 10 month period, total hospital admission count reduced by 45% with total length of stay reduced by 47%. For Maori, admission count reduced by 43% and length of stay reduced by 45%. For Pasifika, admission count reduced by 37.5% and length of stay reduced by 8%. Clinical outcome measures are currently being analysed in retrospect.

Conclusion: The impact of this pathway redesign on hospital admissions far exceeded our expectations. While Maori were initially over represented in the admission and length of stay data, they are now found to have a shorter length of stay than total average. Pasfika people continue to have longer length of stay when admitted therefore we acknowledge there is work to do in this area.


Aoife O’Reilly is the team leader for speech-language therapy at Wellington Regional Hospital. Her clinical background is primarily in neuroscience and critical care. Liv Thompson-Williams is an advanced speech-language therapist in Head & Neck Oncology at Wellington Regional Hospital. Liv and Aoife strongly advocate for early intervention, inter-professional practice, and improving equity.

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