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Fast tracking lung cancer patients

Fast tracking lung cancer patients

What is lung cancer?

Lung cancer is the leading cause of cancer deaths, accounting for 19% of cancer deaths in New Zealand. The 5-year cancer survival rate in New Zealand is 10.4% compared to 14% in Canada and Australia

What are we trying to achieve?

In 2014, the Ministry of Health (MoH) introduced the Faster Cancer Treatment (FCT) targets (see diagram below). The primary target is for patients with high suspicion of cancer to receive the First Cancer Treatment within 62 days of the initial referral from a general practitioner or other health practitioner to a lung specialist in our hospital.

Ministry of Health Faster Cancer Treatment (FCT) targets

Our aim is to improve our compliance against the MoH target of 85% compliance.

What did we find?

An audit of new lung cancer patients for the four Northern Regional DHBs in 2014 showed that only 56.6% of patients met the 62-day target.

What have we done?

  • We conducted a pilot for Single Point of Access of Care (SPOAC) across the four Northern Regional DHBs from Feb to May 2015
  • We developed a predetermined pathway which included:
    • designated cancer coordinators, radiologists and clinicians to support robust grading of cancers
    • use of virtual clinics to plan next best investigation and upfront CT/PET scan for selected patients to reduce the number of diagnostic investigations
  • The SPOAC pathway was formally adopted for lung cancer workup from 1st October 2015

Did we make a difference?

We compared results post adoption of the SPOAC pathway (Oct 2015 to Jan 2016) with data during the pilot period (Feb to May 2016), and historical data (Jan to Jul 2014). Our results post adoption showed that we achieved:

  • 85.5% compliance for 62-day target to First Cancer Treatment compared to 56.6% historically (92.5% achieved during pilot)
  • 81.5% compliance for 14-day target to First Specialist Assessment (FSA) compared to 62.2% historically (83.8% achieved during pilot)
  • Median of 31 days from initial referral to Decision to Treat (DTT) compared with 37 days historically (median of 26 days achieved during pilot)