CARING FOR HEAD & NECK CANCER PATIENTS WITH EXCELLENCE (CHANCE)
Care Process & Redesign
National Healthcare Innovation and Productivity Medals
National University Health System
27 January 2026
To increase % of patients reviewed by Speech Therapist within 2 weeks of starting chemoradiation to 70%. It would be prudent to continue current practices to measure further long-term benefits.
Year Submitted: 2025
Published Date: 27 January 2026
Tags: Care Process ＆ Redesign, Workflow Redesign, Cost Saving, Quality Improvement, Productivity
About this Content
Aims
To increase % of patients reviewed by Speech Therapist within 2 weeks of starting chemoradiation to 70%
Background
Patients with head and neck cancers being treated with chemoradiation have 80% risk of developing swallowing dysfunction due to pre-existing cancer involvement of vital structures as well as acute and chronic sequelae of treatment side-effects. This leads to complications such as aspiration, dehydration, malnutrition, weight loss, need for enteral feeding, reduced quality of life. Major guidelines have recommended for multidisciplinary team involvement, including formal speech and swallowing evaluation, prior to treatment initiation.
Methods
Interventions were implemented to address root causes such as doctor's lack of knowledge, patient's inconvenience, absence of a workflow, cost concerns, and fears of needing NGT/enteral feeding.
Results
73% of patients were reviewed by ST within 2 weeks of chemoRT, 81% of patients had at least 5% weight loss, 11% of patients required enteral feeding, 15% of patients were hospitalised due to complications.
Conclusion
It would be prudent to continue current practices to measure further long-term benefits.
Lessons Learnt
The project team managed to achieve the primary aim, and there appears to be benefit in terms of patient outcomes including degree of weight loss, need for enteral feeding, hospitalization. This translates to better job satisfaction for healthcare workers and significant cost savings.
Keywords
Cancer, Chemoradiation, Swallowing Dysfunction, Enteral Feeding, Quality of Life
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | National University Cancer Institute Singapore, National University Hospital |
Platform(s) | National Healthcare Innovation and Productivity Medals |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Haematology, Oncology |
Project Lead(s) | Kenneth Sooi |
Project Member(s) | Jemima Leung |
Connect with this contributor!
Kenneth Sooi - kenneth_sooi@nuhs.edu.sg
Project Attachment
430_NUCIS_NHIP_2024_CARING_FOR_HEAD_NECK_CANCER_PATIENTS_WITH_EXCELLENCE_CHANCE.pdf