Fast track clinic speeds up Northland lung cancer response

Telling patients whether they have lung cancer or not is now being done on average 18 times more quickly, thanks to the implementation of the Respiratory Fast Track Clinic service in Northland.

In March 2016 Northland DHB sought to implement a Respiratory Fast Track Clinic copying and improving on a One Stop Shop model adopted by Southern District Health Board in 2009.

Respiratory physician Dr Stephen Iles, clinical nurse specialist lung tumour stream Mandy Glaze and Faster Cancer Treatment Project manager Annette Becker had a vision to set up the same concept of the One Stop Shop in Northland.

The One Stop Shop concept means a single appointment and includes a First Specialist Assessment, CT (computed tomography) scan, follow-up and diagnosis. The model of care was improved by performing additional types of biopsies (CT Guided /or Bronchoscopy biopsies) on day one instead of across four or five days.

This project was successfully completed last year and early results show a startling improvement in wait times to be seen, investigated and treated for lung cancer.

“Key for us was the opportunity to reduce anxiety and stress to patients and whānau by reducing the time between the referral and diagnosis of cancer,” Dr Stephen Iles said.

“This initiative demonstrated that the services involved collaborated together and had a ‘can do attitude’ with the staff making sure it was all about the patient and making improvements to their journey.”

Prior to the establishment of the Respiratory Fast Track Clinic service the process would normally require the patient to attend four to five appointments on separate days.

The clinical team’s aim was that 100 percent of patients triaged as high suspicion of cancer and would take 20 days from receipt of referral to Diagnosis.

“What we found was that one third of our patients didn’t have cancer and they could be given that news on the same day as their appointment which immediately relieved an enormous amount of anxiety,” Dr Iles said. “For those people who were diagnosed with lung cancer we were able to determine a pathway of treatment as soon as possible.”

Lung cancer remains New Zealand's number one cause of cancer death, killing more than 1600 people a year. NZ’s survival rate is lower than some other countries. Around 10 percent of New Zealand lung cancer patients are alive five years after diagnosis, compared with 12 to 16 percent in Australia and the United States.

“Clearly we are still very focused on preventing lung cancer which means eliminating smoking, however, given lung cancer is the number one cancer killer for men and women the sooner we can diagnose it the better.”

“It you have a persistent cough for a month or so you are well advised to go and see your GP as soon as possible.”

The Respiratory Fast Track Clinic service is now standard operating practice at Northland DHB, which is encouraging all other DHB’s in New Zealand to adopt the same model of care.

The multi-disciplinary Respiratory fast Track Clinic team including Dr Stephen Iles (middle row far right), clinical nurse specialist lung tumour stream Mandy Glaze (middle row next to Dr Iles) and Faster Cancer Treatment Project manager Annette Becker (middle row third from the right).

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