Author(s): Beattie V.; Shepherd P.; Guerin M.
Source: Journal of Thoracic Oncology; Oct 2018; vol. 13 (no. 10)
Publication Date: Oct 2018
Publication Type(s): Conference Abstract
Abstract:Background: Approximately 44,000 people are diagnosed with Lung Cancer in the United Kingdom (CRUK,2012). In Liverpool we serve a population of 330,00. As health care providers we constantly look to new models of care to aid earlier diagnosis. Introduction of a new referral system into the diagnostic service at our hospital including: pre planned investigations prior to first outpatient appointment, it was identified that some pre planned investigations were inappropriate for some patients due to unknown performance status and co-morbidities. There was an increase in patients failing to attend outpatient appointments. The Lung CNS team looked provide intervention to provide patients with early access to key worker support with the aim of enhancing and reducing the lung cancer pathway Method: In 2016 a pre assessment proforma was developed. CT scan reports and referrals are assessed by Lead Lung Physician and appropriate referrals forwarded to Lung CNS. Lung CNS team contact patients via telephone and a pre assessment proforma completed. Patients informed of date of outpatient appointment need for investigations and explanation provided of what to expect. Holistic needs assessment undertaken to enable any concerns to be raised and allow early intervention by the specialist team with an aim of improving symptoms and performance status prior to commencing a treatment pathway. Result: Initial audit results looking at case studies, failure to attend rates and patient satisfaction met our objectives. There has been a reduction in failure of patients attending investigations; reduction in cancellation of prebooked investigations; provides early rapport between lung CNS and patient/carer with earlier recognition of symptoms and earlier access to urgent treatments; allows health education prior to first outpatient appointment including: smoking cessation; exercise and nutrition. Conclusion: This work has been an opportunity to demonstrate a positive impact on the patient pathway by streamline complexities in the pre diagnostic phase. Whilst it had a marked impact on the Lung CNS job plan it accommodates a growing demand on a constrained service. A revised job plan has been put in place for Lung CNS, there is improved communication and coordination between departments, importantly patients view this service positively. Keywords: assessment, telephone, holistic
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