Organizational Guidance for the Care of Patients With Head and Neck Cancer in Ontario
Irish, J., Kim, J., et al. (2019).
Toronto (ON): Cancer Care Ontario, (Program in Evidence-Based Care Guideline No.: 5-3ORG Version 2).
<div>This updated guideline provides recommendations regarding the minimum requirements necessary for the organization and delivery of multidisciplinary care to individuals with head and neck cancer. It also provides recommendations pertaining to minimal staff volumes and training to provide optimal care. The intended audience includes administrators and healthcare professionals.</div>
Ontario Health (Cancer Care Ontario)
<div>This guideline is an update to the following guideline:</div>
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<ul>
<li>Gilbert, R., Devries-Aboud, M., et al. (2009). <em>The Management of Head and Neck Cancer in Ontario: Organizational and Clinical Practice Guideline Recommendations.</em>Toronto, ON (Canada): Cancer Care Ontario, (Program in Evidence-based Care Evidence-Based Series No: 5-3), 1-38.</li>
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<div>This guideline is supported by the following article:</div>
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<ul>
<li>Irish, J., Kim, J., Waldron, J., et al. (2020). Organizational Guidance for the Care of Patients With Head-and-Neck Cancer in Ontario. <em>Current Oncology, 27</em>(2), e115-e122. doi:10.3747/co.27.5873</li>
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<div>Adults with head and neck cancer should be cared for by a multidisciplinary team that includes a speech-language pathologist as part of the core team. The core team is the group of clinicians responsible for assessment, treatment, management, and rehabilitation of new patients with head and neck cancer. The members of the core team should coordinate care to ensure it is optimally effective and safe. </div>
<div>Speech-language pathologists treating individuals with head and neck cancer should, at a minimum, have the following skillset:</div>
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<ul>
<li>a Master’s degree (or equivalent) in speech pathology;</li>
<li>knowledge and expertise in clinical swallowing assessment, video fluoroscopic swallowing assessment, swallowing therapy, and the management of patients with tracheotomies; and</li>
<li>specialized training in tracheoespohageal puncture (if conducting voice restoration work for patients with laryngectomy).</li>
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<div>To ensure adequate access to assessment and treatment, at least 1.0 full-time equivalent SLP is needed per every 150 head and neck patient served at a center.</div>
<div>The recommended infrastructure requirements for speech-language pathologists include:</div>
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<li>Specialized equipment for speech rehabilitation post-laryngectomy</li>
<li>Availability and access to radiology for completion of modified barium swallow studies and equipment to support the analysis of swallowing function</li>
<li>Access to space to see patients collaboratively and independently, including the ability to assess drop-in patients</li>
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