Abstract
Patients with lung cancer often experience stressful delays throughout the diagnostic phase of care. To address that situation, our multidisciplinary team created a "Navigation Day," during which patients partake in a single-day visit that comprises nurse-led teaching, social work, smoking cessation counselling, symptom control, and dedicated test slots for integrated positron-emission tomography and computed tomography (pet/ct), pulmonary function tests (pfts), and magnetic resonance imaging (mri) of the brain. We evaluated the effects of that program on wait times and patient satisfaction. Patients with a suspicion of lung cancer on chest ct imaging referred during 3 time periods were reviewed: 1 year before launch of the Navigation Day, 1 year post-launch, and 2 years post-launch. Patients were further stratified according to concordance of their test date with a Navigation Day date. Mean wait times for pet/ct, pfts, and mri brain were calculated for each group. Patient satisfaction was measured using a standardized provincial survey. The Student t-test and analysis of variance were used to assess for significance. After implementation, mean wait times in the first year improved to 9.2 days from 15.5 days for pet/ct (p < 0.0001), to 9.6 days from 15.7 days for pfts (p < 0.0001), and to 10.2 days from 16.0 days for mri brain (p < 0.0001). Patients who used a dedicated test slot experienced the shortest wait times, at 5.8 days for pet/ct, 5.8 days for pfts, and 6.3 days for mri brain (p < 0.0001). Those improvements were sustained at 2 years post-launch. Patient satisfaction in the categories of assistance, emotional support, and clarity remained high post-launch. Navigation Day significantly improved the timeliness of diagnostic testing services in patients with suspected lung cancer.
Highlights
In Canada, lung cancer is the leading cause of cancer death in both men and women
Navigation Day significantly improved the timeliness of diagnostic testing services in patients with suspected lung cancer
Further improvements in mean wait time from 1 year post-launch to 2 years postlaunch were seen for all tests, and the difference was statistically significant for mri brain (p < 0.0001)
Summary
In Canada, lung cancer is the leading cause of cancer death in both men and women. It is responsible for the deaths of approximately 21,100 people annually, which is more than colorectal, breast, and prostate cancers combined[1]. Patients suspected of having lung cancer often go through a plethora of providers, examinations, delays, and specialists to obtain a diagnosis and treatment. This diagnostic phase of care can be an extremely anxiety-provoking and stressful experience, often with multiple appointments being needed and delays being encountered. Reducing those delays has been shown to relieve patient anxiety in patients suspected of having lung cancer[2]. Patients with lung cancer often experience stressful delays throughout the diagnostic phase of care. We evaluated the effects of that program on wait times and patient satisfaction
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