Cutting cancer waiting times: streamlining cervical lymph node biopsy

Abstract

Patients with enlarged lymph nodes present to a number of different specialties and diagnosis is often made following a biopsy. This study aimed to establish department waiting times for cervical lymph node biopsy, and compare these to the cancer services guidelines. A retrospective audit was carried out to record patient waiting times (defined as the number of days from referral to biopsy) between May and December 2010. A proforma for referral was introduced. In addition, appointments for biopsies were arranged by a co-ordinator. A prospective re-audit was carried out from March to September 2011. The first audit showed that national guidelines were not met; there was a median waiting time of 74 days (interquartile range, 47-113). Re-audit demonstrated a significant reduction in waiting times using the proforma; the median waiting time had decreased to 18 days (interquartile range, 9-22). A proforma for lymph node biopsy and a designated co-ordinator streamlined the service, significantly reducing waiting times. Together, these can aid referral for meeting guidelines and improve patient care.