Table 2.

Clinicians’ identified top 10 solutions for delayed diagnosis of cancer

Rank	Proposed solution to delayed diagnosis of cancer	Priority score	Categories of Organizational Interventions to Decrease Diagnostic Errors	Type of delay the proposed solution is aimed at
1	Encourage public awareness campaigns on common symptoms of cancer to ensure patients present early in the course of their disease	94.1	Patient education and empowerment	Patient delay
2	Improve adherence to referral guidelines to ensure earlier diagnosis	93.3	Educational intervention	Referral delay
3	Improve communication between general and oncology teams in hospitals to improve the standard of care	93.3	Structured–process change	Referral delay
4	Provide prompt feedback to primary care if delayed diagnosis to encourage learning about incidents	90	Educational interventions	Primary care delay
5	Facilitate rapid referrals from primary care to hospitals	89.2	Structured–process change	Referral delay
6	Improve specialist education for doctors and nurses to ensure better standards of care	89.2	Educational interventions	Secondary care delay
7	Improve funding provided to improve services available and provide quicker access to diagnostics and specialists	87.5	Structured–process change	Referral delay
8	Improve access to GPs for patients to ensure earlier diagnosis	85.8	Structured–process change	Patient delay
9	Improve referral and follow up processes to ensure referrals are not lost	85.8	Structured–process change	Referral delay
10	Ensure sufficient staff available to deal with referrals to ensure no delay in processing referrals	84.1	Personnel change	Referral delay

The table uses clinicians’ verbatim statements which were only exceptionally reworded for clarity. Clinicians scored solutions using the following criteria: feasibility, cost–effectiveness and potential for saving lives (Box 1). The scoring options were 1 for “yes” (eg, this problem is common), 0 for “no” (eg, this problem is uncommon), 0.5 for “unsure” (eg, I am unsure if this problem is common) and blank for “unaware” (eg, I do not know if his problem is common). Total priority score is the mean of the scores for each of the three criteria and ranges from 0 to 100. Higher ranked solutions received more “Yes” responses for each of the criteria and a higher score.