Quality Improvement Study for LUNG CANCER
Renown Health has provided Low-Dose Computer Tomography or Low-Dose CT( LDCT) as an option for community members for several years. The program was a provider-referral, self-pay program that a Nurse Navigator facilitates through identifying the appropriateness of the referral and worked with patients and providers to assure appropriate follow-up.
When best practice guideline recommendations were released by the US Preventive Service Task Force( USPSTF), Renown Institute for Cancer began planning the implementation of a comprehensive Lung Cancer Screening Program( LCSP). The new program was implemented March of 2016 following a process improvement project supported by a multidisciplinary team. The team’ s main objective was to increase the number of early stage lung cancer diagnoses( stage 0, 1, 2) and decrease the number of late stage lung cancers( stage 3, 4) in our program. This goal would be accomplished through early detection screening using the newly published evidenced-based guidelines which use LDCT. This quality improvement project will drive toward increasing the chance of five-year survival to 90 percent for our patients diagnosed with lung cancer. Implementation of the program throughout the Renown organization required a number of initiatives including:
• Enhancement of our Electronic Medical Record( EHR) to automate reminders to our providers by adding a Best Practice Alert( BPA) reminder.
• Development of a referral process for patients to first meet with an Advanced Practice Nurse for education and a“ Shared Decision Making” visit prior to the screening LDCT.
• Development of a standardized reporting system to assure appropriate follow-up which may include schedule for future screenings, referral to the Lung Nodule Clinic or referral for cancer treatment.
• Development of a process to submit all results to a new lung screening registry, American College of Radiology( ACR) Lung Cancer Screening Registry, for national tracking and reporting.
Results prior to improvement project:
Avg Referred / Screened Patients / Year |
Cancers Diagnosed |
100 |
1 |
Results for the first six months of the new program:
Patients Referred
Patients Meeting All Criteria
Patients Screened
Patients Biopsied
Cancers Diagnosed( Stage)
211 127 105 8 2( 1)
The program continues to grow, with an expected 450 percent increase in patients referred and a 250 percent in patient screened from prior years. All patients with suspicious lung nodules have been referred to the Renown Lung Nodule Clinic and all cancer diagnosed have been early stage and referred for the appropriate treatment. The long-term goal of reducing the late stage cancers and increasing the early stage cancers diagnosed has just begun. The program will be monitored and reported on annually.
Talk to your doctor to see if you meet the criteria for lung cancer screening.
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