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Disease Pathway Management


The pathways help to identify gaps in care and set quality improvement targets.

Pathways are used as a tool to improve quality, access, appropriateness and coordination of care across the patient journey.

By 2015, pathways for the most common types of cancer will be produced.

Read more about Pathways

Disease Pathway Management is a unifying approach to the way we set priorities for cancer control, plan cancer services and improve the quality of care in Ontario.

Developed in 2008, Disease Pathway Management applies a framework for examining the performance of the entire system across the cancer journey – from prevention to recovery and end-of-life care – and identifies any gaps and bottlenecks along the way.


  • To identify areas for improvement in the quality of care, processes and the patient experience
  • To develop and disseminate operational tools to facilitate improvement in those areas

Disease Pathway Management uses a disease-specific approach and focuses on one type of cancer at a time, with the understanding that the patient journey differs from one cancer to another. 

Disease Site Approach

For each disease site, a multidisciplinary team (including clinicians, health administrators, and patients from across the province) works together using a phased approach to:

  • develop and disseminate pathways that depict the patient journey,
  • identify and prioritize any gaps in care, evidence-based guidelines and measurements,
  • engage the Ontario cancer community on these issues through tailored regional sessions, and
  • identify provincial performance measures with which to monitor progress.

Progress on Disease Site Approach


Spotlight: Dyspnea Care Initiatives

Dyspnea, or shortness of breath, is a distressing symptom that occurs in approximately 75% of Ontario lung cancer patients. The improvement of dyspnea care for lung cancer patients was identified as one of the priorities for action for lung cancer care. In 2010, Disease Pathway Management provided funding to seven regional cancer centres across Ontario to implement dyspnea care initiatives. This recommendations report summarizes the lessons learned from these pilot projects sites and provides guidance regarding the effective implementation of a dyspnea care initiative. The goal of this report is to catalyze action toward improving dyspnea care across Ontario, in alignment with the strategic priorities of the Ontario Cancer Plan III.

To learn more about dyspnea, please view: Symptom Management Tools


Prostate cancer Disease Pathway Management was officially kicked off in February 2011. Six Priorities for Action were identified to improve the quality of care, processes and patient experience for prostate cancer and the team is now working with Cancer Care Ontario’s Clinical Programs to facilitate action against these goals. Additionally, two improvement projects were funded for selected regions, namely, the Prostate Cancer Patterns of Care Project (ensuring appropriate patterns of care (referrals) for consultation to both a urologist and radiation oncologist prior to treatment decision) and the Prostate Cancer Risk Stratification Proof of Concept Project (timely and systematic collection of relevant data elements to be able to risk stratify newly diagnosed Ontario prostate cancer patients). Regional engagement sessions will be held for this disease site in Spring 2013 and will highlight these projects as well as provide an opportunity to further discuss regional improvement strategies.

The Prostate Cancer Disease Pathway Management Priorities for Action Report provides an overview of the Prostate DPM approach and sets provincial and regional focus on the priorities in order to achieve improvements across the prostate cancer journey. A brief synopsis of this document is provided in the Prostate Cancer Disease Pathway Management Priorities for Action Summary.

Colorectal and Lung

Spotlight: Regional Improvement Projects

Disease Pathway Management has provided quality improvement funding to each regional cancer program in Ontario to conduct regional improvement projects focusing on either colorectal cancer or lung cancer. The purpose of these improvement projects is to help address the lung cancer and colorectal cancer priorities for action, outlined in the Disease Pathway Management Priorities for Action Reports below. Regions had the option of choosing one or more colorectal and lung cancer priorities for action and developed an improvement project to address it.

This approach provides the regions with the opportunity to work on locally relevant priorities and allows for creativity in the solutions proposed. To date, Disease Pathway Management has funded more than 20 regional improvement projects.

The Colorectal Cancer and Lung Cancer Disease Pathway Management Priorities for Action Reports provide an overview of the DPM approach and set provincial and regional focus on the priorities in order to achieve improvements across the colorectal cancer and the lung cancer journey.

Regional engagement sessions for these disease sites were completed in late 2011. In these sessions, disease site clinical co-chairs travelled to each regional cancer program to discuss the Priorities for Action with the relevant cancer system stakeholders.

Each session included the presentation of regional data to facilitate the discussion of issues and ideas at a local level. Some of these discussions led to the implementation of Regional Improvement Projects (see Spotlight, at right).

With the regional engagement sessions complete, the colorectal and lung DPM teams will be entering the next phase, which is performance measurement.

Last modified: Fri, Apr 25, 2014
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