Authors (including presenting author) :
Yeung WWK(1), Chau YL(1), Lau RWH(1), NG CSH(1), Wan IYP(1), Chui ST(1), Wong RHL(1)
Affiliation :
1 Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital
Introduction :
Lung cancer is one of the most common types of cancer in Hong Kong and there are about 4000 new cases each year. A study has revealed that for every week delay of surgical resection after staging, approximately 4% increase of pathologic upstaging frequency was observed. This marks the importance of timely investigation, staging and intervention for this group of patients. Prince of Wales Hospital (PWH) cardiothoracic team works together with other professional teams to provide therapeutic treatment to patients with suspected lung cancer. Every year, over 70% of elective thoracic operations performed in PWH are related to lung cancer. However, due to long waiting queue in specialty out-patient clinic (SOPC), the routine schedule booking for new referral was about 4 months. In view of this, an initiative of Fast-track assessment clinic runs by experienced cardiothoracic advanced practice nurses (APN) was taken place.
Objectives :
- To shorten waiting time and provide timely assessment for patients with suspected lung cancer.
- To share doctor workload and reduce unnecessary attendance in doctors’ clinic session.
Methodology :
Since January 2020, a cardiothoracic nurse clinic was set up for providing fast-track assessment for patients with suspected lung cancer. New referrals would be first preliminary screened and triaged to the clinic by surgeon. All referred cases would be discussed with surgeon before every clinic visit. On the day of visit, according to preset protocols, responsible cardiothoracic nurses obtained relevant information, performed physical assessment, stratified risks, explained disease progress, arranged and ensured necessary investigations were ready for treatment planning before 1st doctor consultation. Treatment plan would be decided and planned interventions could be started at once after doctor consultation.
Result & Outcome :
In the year 2020, total 164 cases were referred to the fast-track assessment clinic. Excluded those defaulted cases, the average time from received referral to clinic visit was 15.7 days, in which patient waiting time was enormously shortened when compared to the routine booking in SOPC. Also, total 164 doctor clinic attendances were saved during the said period. To conclude, the fast-track assessment clinic runs by experience cardiothoracic nurses able to shorten patient waiting time and reduce doctor unnecessary clinic attendance.
