The Queen’s Brain Tumor Program (QBTP) is revolutionizing the way post-operative brain tumor care is delivered in southeastern Ontario.
In spring of 2023, Dr. Teresa Purzner, a clinical scientist and neurosurgeon at Queen’s University and Kingston Health Sciences Centre (KHSC), and her clinical research team set out to conduct a retrospective review of patient data. The team, which includes Sarah Asselin, MScN ’24, PhD candidate Matthew Love, Abby Mocherniak, MSc ’24, and Danny Toon, MScN ’24, realized there was a bigger problem when it came to brain tumor patient outcomes in southeastern Ontario—a problem they could address through their research.
Glioblastoma multiforme (GBM) is an aggressive, fast-growing type of brain tumor. This tumor type is the focus of the QBTP, which launched on Dec. 4. GBM patients in Canada have a median survival length of eight months, with less than 5 per cent of patients surviving at least five years.
“Our glioblastoma patients were getting safe operations and were getting lost in the system after that. There was a lot of room for improvement to help ensure every glioblastoma patient is receiving the most timely care possible,” Toon said in an interview with The Journal.
Given the limited prognosis of untreated primary brain tumors after surgery, it’s crucial their post-operative cancer treatments are delivered in a timely manner.
The Cancer Centre of Southeastern Ontario (CCSEO) operates from Kingston General Hospital (KGH) and oversees cancer are for patients ranging from Leeds and Grenville counties to parts of Lanark and Northumberland counties. Because the CCSEO services such a large geographic region, many patients must travel several hours to access care.
Mocherniak said this can be particularly challenging for GBM patients as radiation treatments are typically istered for several days back-to-back.
“That was one of the biggest things that was going on with patients, and that was a kind of challenge our healthcare system in Canada just wasn’t compatible with, so it was an opportunity for growth,” Mocherniak said in an interview with The Journal.
Suspected GBM patients are typically referred to the program by physicians, where a nurse navigator is assigned to their case and follows their care through the system. The nurse navigators act as a primary point of for any questions the patient may have, and they’re able to communicate with the rest of the care team to ensure treatment schedules are followed.
“We wanted to streamline and standardize the flow of patient care,” Mocherniak said. “We now get a direct referral from all hospitals that are in our catchment region in southeastern Ontario.”
The program is unique because it isn’t just focused on clinical care or patient —it takes a holistic approach to integrate patient education and with translational research and clinical innovation. Mocherniak said with such an aggressive and rapidly progressing disease, a streamlined approach to care is important and significantly impacts patient outcomes.
“The QBTP has a mission to improve patient care, not just meet the standard of care,” Toon said.
Healthcare programs are typically developed using a Quality Improvement (QI) framework that seeks to systematically improve care. Purzner’s team felt that to achieve an effective outcome, they would need to deviate from this model.
Drawing on past experiences, Purzner and her team chose to implement a design thinking approach. This framework is traditionally used in business and entrepreneurial settings—implementing it in a healthcare setting hadn’t really been done before.
“Design thinking itself is rooted in the people it’s affecting. In business, design thinking is focusing on what the people want from a consumer perspective and creating a product that really works for them, whereas in healthcare we’re using it to create a program that works for all the different people on all the levels,” Mocherniak said.
Throughout the development process, the team consulted with patients as well as a wide variety of healthcare providers and s to get a clear sense of each stakeholder’s needs and priorities.
“We used that [information] to create a program that not only was patient-centric and focused on what the patients actually need and what they tell us they need, and then also was feasible and beneficial to the healthcare providers that would then be using it,” Mocherniak said.
Toon said the program is constantly evolving through an iterative process. The team hopes the program will continue to develop to reflect the needs of its patients and providers.
If the program is successful, the team is hopeful other regions may adopt the same approach.
“There are a lot of different types of brain tumors. We’re only focusing on glioblastomas, but it would be nice to have the resources to expand to all brain tumor patients,” Toon said.
In the future, Mocherniak would love to see a widespread implementation of programs like the QBTP and increased healthcare accessibility in Canada, especially for rural patients.
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