Article Text

PDF
P81 Straight to CT delivers earlier first definitive treatment in lung cancer– effect of a simple intervention
  1. P Malhotra,
  2. P Murphy,
  3. C Dawson,
  4. N Hunt,
  5. J Hendry
  1. St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK

Abstract

Background The National Optimal Lung Cancer Pathway (NOLCP) recommends performing a CT scan before a patients first appointment in a rapid access suspected lung cancer clinic. A local audit in 2014 at our hospital which receives over 350 two week rule suspected lung cancer referrals per year found that less than 50% of patients had a CT scan before their first appointment.

Objective To determine the effect of a simple cue for physicians stamped on 2 week rule referral forms on the proportion of patients who have a CT scan before their first appointment in a rapid access suspected lung cancer clinic, and its effect on the time to definitive treatment.

Methods This was a retrospective analysis of the lung cancer clinic database at a large district general hospital. Two periods were audited: September – November 2014 (pre-intervention), and July – September 2015 (post-intervention). Data on demographic characteristics, date of first clinic, date of performance of CT scan, and time to definitive treatment was collected. From January 2016 onwards, a simple new intervention was put in place: all 2 week rule referrals were stamped with a cue (“Pre-clinic CT: Yes or No?”) for Consultants triaging the referral to prompt them to arrange a pre-clinic CT scan if appropriate. Re-audit was carried out during the period July–September 2015.

Results Seventy-six out of 81 two week rule referrals between September–November 2014 had a CT scan during their management pathway. Thirty-six (47%) of these scans were performed before the patients first appointment in clinic. Re-audit between July-September 2015 after introduction of the stamp revealed that 88 CT scans were performed on 101 two week referrals. Of these, 70 (80%) patients had a CT scan before their first appointment.

Time to first definitive treatment improved by 1 week from 38.7 days in the pre-intervention cohort, to 31.5 days in the post-intervention cohort.

Conclusion A simple cue stamped on 2 week rule referral forms increased the proportion of patients who had a CT scan before their first appointment in a rapid access suspected lung cancer clinic from 47% to 80%, and reduced the time to definitive treatment by 1 week.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.