P1.07-05 Developing a Nursing Triage Tool to Assess Patient Support Needs Through Treatment for Lung Cancer

Abstract

Improvements in treatments and outcomes within lung cancer has resulted in an increasing number of patients requiring access to appropriate support. Within a tertiary specialised centre for the treatment of lung cancer, stratification of support is required in order to target the patients with the greatest needs and identify services to sign post them to. The Lung cancer Clinical Nurse Specialists (LCNS) are developing a triage tool which uses a red, amber, green approach to stratifying need. It assesses 10 areas of patient vulnerability. On completion of the assessment, those with particular needs will be triggered by an amber or red flag. The tool will proactively identify patient need, whilst helping the LCNSs to work towards a manageble caseload. The LCNS team had been assessing patient need through intuition, using their own criteria. The aim of the tool was to create a consistent approach to this assessment and led to the identification of key areas of patient vulnerability. Already validated tools for these key areas were incorporated into the design. A scoring system was developed against each key area and the tool was piloted on a number of patients in order to identify the boundaries of stratification. However, due to the variability in scores and inconsistent outcomes, scores were replaced with red, amber or green for each category. Any category resulting in an amber or red outcome, led to a more complex intervention. All Green Outcomes: Information pack, LCNS contact details, referral back to local CNS Any Amber Outcomes: In addition to the 'Green' interventions, a day 8 (of treatment) telephone consultation in nurse led clinic, Community referrals Any Red Outcomes: In addition to the 'Green and Amber' interventions, follow up call post initial consultation, specialist service referrals The tool will be further piloted by the LCNSs and interventions implemented in line with the outcomes. The aim is to roll the tool out across the Greater Manchester area so that it can be used by CNSs in the District General Hospitals and will be continually used throughout the patient pathway as their needs change. The resulting assessment will be recorded on the electronic patient record and therefore will be auditable across the patient population to ensure that LCNS patient interventions are at the appropriate level to the support need. Outcome measures: - Reduced hospital admissions - Improved outcomes for patients - Patient Satisfaction through service user feedback Identifying patient need through their cancer pathway has until now been a process of intuition and individual preference by each LCNS. This triage tool, whilst not replacing clnical judgement, is designed to remove the inconsistency of assessment and create a stratified approach to patient need. This will enable appropriate allocation of resources and provide auditable data to allow service improvement and ultimately enhance the patient experience.