Abstract
BACKGROUND: In an era of increasing demands on healthcare services, the development of regional oncology networks including care pathways may be instrumental to improve the efficiency and quality of care. However, developing such networks involving numerous stakeholders and hospitals is challenging as no templates exist. This study evaluates the development of a large regional network with the objective to provide a practical template. METHODS: A multicentre survey was conducted between October 1, 2024 and January 31, 2025. Clinicians from the departments of medical oncology, surgery, gastroenterology, pathology, radiology, nuclear medicine, and radiotherapy at the 13 hospitals in the OncoNoVo+ regional oncology network were invited. The survey included open-ended, multiple-choice, and slider questions (score range 0-100 on a visual analogue scale), focusing on baseline characteristics (n = 7), functioning of the network and care pathways (n = 16), and the development process of the care pathways (n = 6). RESULTS: Overall, 216 medical specialists, researchers, nurse specialists, and case-managers from 13 hospitals developed six care pathways (esophagogastric, pancreatic, small intestinal, rectal, liver, and biliary tract cancer). In the survey, 135 (63%) clinicians participated. Median scores of 75 or higher were observed in nine out of 11 satisfaction statements. Highest scores were observed for statements about the importance of regional care pathways, the recommendation of pathways outside the region, and the effectiveness of the OncoNoVo+ app (median, 85 [IQR, 75 to 97], 85 [75 to 99], and 84 [75 to 95], respectively). Mentioned 'essential factors for success' included coordination, collaboration, technology, and mutual respect. 'Improvement factors' included clearer implementation, better communication, regular updates, and equal involvement across hospitals and specialties. CONCLUSION: The multicenter development and maintenance of regional care pathways for patients with gastrointestinal cancers within a regional oncology network seems feasible and effective with high satisfaction among participating hospitals. Implementation, communication, and equal involvement of centers and medical specialties deserve utmost attention.