The Accreditation Working Group of the Cancer Centre at the East Hospital continues its work, developing a methodology and finalising the design of patient pathways

Experts in the field of oncology at Riga East Clinical University Hospital (hereinafter – the East Hospital) continue their work on the accreditation of the National Cancer Centre. To ensure a multidisciplinary approach to cancer treatment for all oncology patients in Latvia in accordance with European guidelines, experts in the field of oncology at the East Hospital, together with experts from the Organization of European Cancer Institutes (OECI), are working on organising methodological management issues and finalising the design of patient pathways.

European guidelines for cancer treatment emphasize the importance of receiving quality information about all stages of the treatment process. They also advocate for providing specific and complex cancer treatments as close to the patient’s residence as possible and, if feasible, within their usual social environment.

The methodological management entails that experts at the East Hospital have the right to analyse the entire medical history and examination data of a patient, and, for new patients, make decisions on treatment approach and provide recommendations through a multidisciplinary consultation. Currently, the draft regulation regarding the above-mentioned oversight is being forwarded to the Cabinet of Ministers. Meanwhile, in parallel with regulatory framework, experts in the field of oncology at the East Hospital are working towards accreditation at the European Cancer Institute in the future. This includes the implementation of methodological management in cancer treatment.

Professor Sandra Lejniece, Head of the Chemotherapy and Hematology Clinic at the East Hospital, points out: “We familiarise ourselves with the experience of leading foreign clinics, consult with European experts, and explore various solutions. Significant and time-consuming work is underway to create and organise substantive information. We collaborate with foreign experts who provide consultations. We provide clarifications and prepare the necessary additional information. So far, there has been little focus on educating cancer patients, but we are getting there. For example, once we have education and support nurse for the melanoma and skin cancer patient’s pathway, we will definitely collaborate with representatives of melanoma patient associations in the field of patient education and support.

We must understand that the patient does not embark on treatment with positive emotions, rather with anxiety and concerns. If we can organise the treatment process according to European guidelines, it will change a lot and entail improvements in terms of quality. A significant challenge is the shortage of staff, which is observed not only in Latvia but also in Europe. We search for and train nurses ourselves, and we welcome every doctor who decides to continue working in our hospital with patients in inpatient facilities and providing consultations in outpatient settings.”

Currently, the development of patient pathways for the most common cancer localizations or types has also reached its final stage. Pathways for abdominal tumors, gynaecological tumors, colorectal cancer, melanomas, head and neck cancers, lung cancers, and oesophageal cancers are currently finalised.

Given that cancer treatment involves various experts, there are multidisciplinary teams at the East Hospital that include surgeons, oncology chemotherapists, radiation therapy specialists, pathologists, radiologists, and others. After discussing patient data and test results, multidisciplinary teams provide the patient with a decision on the recommended treatment. After the doctor has explained the decision, the patient takes the final decision on whether or not to initiate the treatment. This represents a significant shift in thinking for healthcare professionals in Latvia, as it has been traditionally assumed that doctors know better about the necessary treatment for the patient. However, before initiating the treatment process, priority must be given to the patient’s will and decision, respecting the patient’s rights.

The accreditation process for the National Cancer Centre has been taking place since 2022 when the East Hospital established a multidisciplinary accreditation team for the centre. The accreditation process is expected to conclude in 2024, with active preparations currently underway.

About the East Hospital

The Riga East Clinical University Hospital is the largest and strategically significant multi-profile hospital in the country. The hospital consists of five inpatient facilities – “Gaiļezers”, “Latvian Oncology Centre” , “Biķernieki”, “Tuberculosis and Lung Disease Centre”, and “Latvian Infectious Diseases Centre”, along with various specialised centres and clinics. The hospital provides highly specialised inpatient and secondary outpatient healthcare, offering multidisciplinary tertiary-level treatment and care in line with modern technology and medical knowledge. Approximately 80% of all cancer patients in Latvia are treated at the hospital. It serves as a practical training base for both Latvian educational institutions and foreign students, providing further education and knowledge transfer to healthcare specialists within and beyond the country. The hospital engages in scientific research and develops innovative methods for patient treatment. As the third-largest employer in the country, the hospital employs around 5000 staff members.