developing a localised lung cancer referral and diagnostic pathway in a regional setting
TRANSCRIPT
Stephen Manley
Cancer Systems Innovation Manager
NNSW LHD
Lisa Delaney
Project Officer: Lung Pathway Project
(Mon & Wed)| NNSW LHD
Lung Cancer Pathways Project:
Local referral and diagnostic pathway
implementation for lung cancer
NNSWLHD Pilot site
Lung Cancer Pathway Project Overview
Statewide project
Project collaborators
– Cancer Service Innovation Managers (CSIMs) Community of Practice (CoP)
– Cancer Institute NSW
– University of Sydney Research in Implementation and eHealth Group (RISe)
– Local Health Districts (LHDs)
– Primary Healthcare Networks (PHNs)
– Lung MDTs
Lung Cancer Pathway Project Overview
Strategic objectives of the NSW Cancer Plan 2011-
2015:
Improving the survival of people with cancer through
the reduction in variations in cancer outcomes across
NSW, reducing the gap between evidence and clinical
practice and reducing the gap between evidence and
policy.
A Toolkit has been funded and developed
Toolkit
Development
Application by non-pilot LHDs
Application to other cancer
sites in the future
Optimal Care
A number of organisations have
developed ‘ideal’ pathways.
‘Optimal Cancer Care for People
with Lung Cancer’ pathway is the
‘National work plan for improving
care in Australia.’
NNSW LHD role
Northern NSW LHD, alongside Sydney South
West LHD, has received funding from Cancer
Institute NSW as the regional pilot site to develop
a referral and diagnostic pathway for lung cancer.
Toolkit: Test and QI .
Mapping current pathways and identification of
barriers to an optimal pathway.
Project Collaborators
Expert Advisory Group:
Professor Tim Shaw (co-chair)
Ms Kahren White (co-chair)
Mr Paul Bennet (HealthPathways Project)
Dr Kate George (GP)
Ms Jill Lack (Newcastle CSIM)
Professor Jane Phillips
Dr Nicole Rankin
Dr Emily Stone (Respiratory Physician, St Vincent’s
Hospital)
Rise
Cancer Institute NSW
University of Sydney
2 pilot LHDs
Project Process
Obtained from lung cancer
pathways toolkit
Current Progress
Stakeholders have been identified and engaged
Continual presence at MDT meeting for ongoing
engagement
Mapping current service is underway
Patient audit to enhance current pathway mapping has
been completed and patient interviews to follow
Stakeholder Engagement
NNSW LHD contains 2 lung MDT groups – Lismore and
Tweed
Mapping Meeting
Service Mapping
Patient Audit
Case 1 = 88 days to treatment
GP
•15/6 CXR Mclean
•26/6 CT Grafton
•30/6 Referred
32d Resp phys
•17/7 consult
•30/7 PET CT
EBUS
•CROSS BORDER
•CG Hospital
•3/8 Referred
Resp Phys
•21/8 consult with EBUS results
•13/8 DOD
MDT
•2/9
Treatment
•11/9 Rad Onc consult
Patient AuditCase 1 = 88 days to treatment
GP
•15/6 CXR Mclean
•26/6 CT Grafton
•30/6 Referred
32d Resp phys
•17/7 consult
•30/7 PET CT
EBUS
•CROSS BORDER
•CG Hospital
•3/8 Referred
Resp Phys
•21/8 consult with EBUS results
•13/8 DOD
MDT
•2/9
Treatment
•11/9 Rad Onc consult
Private
Rooms
Paper
RecordPaper
Record
Paper
Record
Power
Chart
Paper
Record
Power
Chart
Power
Chart
Patient Audit
Case 2 = 14 days to treatment (Palliative case)
GP
•14/8
11d Med Onc
•25/8 Consult
•3/9 CT Biopsy
•2/9 PET
•24/8 DOD
1d ED
•26/8
2d Rad Onc
•28/8 consult
Treatment
•28/8
MDT
•2/9
Patient Audit
Case 2 = 14 days to treatment (Palliative case)
GP
•14/8
11d Med Onc
•25/8 Consult
•3/9 CT Biopsy
•2/9 PET
•24/8 DOD
1d ED
•26/8
2d Rad Onc
•28/8 consult
Treatment
•28/8
MDT
•2/9
Power
Chart
Paper
Record
Private
RoomsPower
Chart
Patient Audit
Case 11 = days
GP
•No record - cross border
MDT
•27/7
•CT
•PET
Treatment
• Surgery
•No record - cross border
Power
Chart
Challenges finding information
Paper record
Private practice information
Information sources
End Product
Establish the preferred pathway utilising information
gathered from stakeholders.
Gain consensus on the preferred pathway from
stakeholders
Utilise Health Pathways to promote the established pathway
to GPs in NNSWLHD
End Product
Advantages
– Awareness
– Avoid delays
– Minimise learning curve
Further work
Established tools to be utilized in other LHDs to develop
their local lung cancer pathway
Utilisation of tools developed to be transferable to other
cancer sites in the future
Stephen ManleyCancer Systems Innovation Manager
NNSW LHD
Locked Mail Bag 11, Lismore 2480
Tel 02 6629 4524 | Fax 02 6620 2355
Mob 0414 662 302
Lisa DelaneyProject Officer: Lung Pathway Project
(Mon & Wed)| NNSW LHD
Locked Mail Bag 11, Lismore 2480
Tel 02 6629 4547 | Fax 02 6620 2355
Lung Cancer Pathways Project
Local referral and diagnostic pathway
implementation for lung cancer
NNSWLHD Pilot site