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Improving Lung Cancer Diagnostics: Histological Confirmation Strategies

Explore strategies to enhance histological confirmation rates in lung cancer services, including diagnostic technology evolution and pathway redesign. Learn from experts on raising HCR profile, improving pathways, and discussing results effectively.

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Improving Lung Cancer Diagnostics: Histological Confirmation Strategies

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  1. ILCOP web conference summary: Histological confirmation rates and diagnostics in lung cancer services 5th July 2011

  2. Lisa Martin, ILCOP QI facilitator, chaired the session • Dr Paul Beckett, Burton Hospitals, presented his experience in improving histological confirmation rates • Dr Paul Walker, Aintree Hospitals, and Tamsin Bendle, Royal Cornwall Hospitals, joined the session.

  3. Discussion summary • How to raise the profile of HCR within your local stakeholders, use local data to generate debate, be prepared to take your discussions to network level, and wider (slides 6-9) • Revise the use of diagnostic technology over time, which may change the point of decision making in the pathway, i.e. as your experience with technology evolves, you become more confident with taking decisions earlier in the pathway, decreasing the time to treatment and the number of steps in the pathway(slides 10 to 14)

  4. Please press F5 now

  5. HCR and Diagnostics Dr Paul Beckett Burton Hospitals NHS Foundation Trust

  6. Histological Confirmation

  7. Burton Hospitals NHS Trust

  8. Histological Confirmation Rate • There is no agreed optimum but it is probably more than 75%….. • Every patient deserves a diagnosis • Histological type influences therapy • “It won’t change management” can now only rarely be justified

  9. How to Improve your HCR • Ensure the team buy in to the importance of HCR • Discuss results in local/national context • Discuss importance of histological subtype and molecular markers • Review availability of diagnostic tests • Are we missing diagnoses we could make on neck FNA, TBNA etc? • Review pathways for diagnostic tests • Don’t feel that you are imposing on people by asking for help • Ensure pathways are clear, simple and efficient for both patients and staff • Example of EBUS….. • Review performance of diagnostic tests • Are our results comparable to the best units?

  10. Diagnostic pathway(please, see as slide show - Press Alt+f5)

  11. Redesigning the Pathway Referral Shorter, more efficient pathway OPA Biopsy CT Scan MDT PET MDT

  12. Redesigning the Pathway Referral CT Scan Biopsy OPA PET MDT

  13. How to Improve your Pathway • Consider process mapping • Look for the bottlenecks • Identify an enabler • Use PDSA cycles to demonstrate effectiveness and slowly bring others on board • Avoid long policy reviews and multiple meetings • Measure to demonstrate change for the better

  14. Let the ILCOP team know if you would like to discuss implementing similar changes within your service. Senai.jimenez@rcplondon.ac.uk Lisa.martin@rcplondon.ac.uk

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