Methods
A core committee was created by the Director of the Head and Neck Cancer Service Line (GSW) including senior leadership from the surgical, medical oncology and radiation oncology services. The first draft was created by the core committee. All physicians and critical ancillary staff were sent a copy of the first draft of the guidelines via email and asked to review the document and make changes in track changes mode. In order to ensure an orderly process, the document was initially sent “Bcc” to the group to expedite individual responses that would then be trackable and avoid the ensuing cross chatter that occurs in groups when documents such as this are sent “Cc” and individuals send their response “Reply to All”. The entire group was assured that every recommended change would be reviewed by the core committee and their changes would either be adopted and if not there would be an explanation from the Director of the Head and Neck Service Line as to why their change was not included. This process allowed for an effective, efficient and timely turnaround in the development algorithm that was inclusive to all stakeholders.