title: The novel use of fast track CT to select patients for lung cancer clinics: effect on clinic efficiency, waiting times, and patient satisfaction.
abstract: BACKGROUND
  Lung cancer is the most common cause of cancer death in the UK, and triaging patients 'straight to test' is recommended to improve patient experience and outcomes. While such pathways are likely to lead to earlier diagnosis and treatment, the data to support this assumption are limited.
  
  
  OBJECTIVE
  To assess the impact of a fast track CT pathway to select patients for lung cancer clinics on clinic efficiency, diagnostic and treatment delays, and patient satisfaction.
  
  
  METHODS
  Retrospective comparative cohort study of patients referred to lung cancer clinics for investigation of suspicious imaging from January to December 2006 and June to December 2007.
  
  
  RESULTS
  The proportion of patients seen in clinic subsequently diagnosed with lung cancer increased from 124/399 (31%) to 86/168 (51%) (p<0.001). Time from referral to diagnosis reduced from 22 to 17&emsp14;days (p<0.001). Time from referral to first discussion at the multidisciplinary team (MDT) meeting fell from 32 to 22&emsp14;days (p<0.001). Time from referral to decision to treat reduced from 42 to 35&emsp14;days (p<0.05). Time from referral to first treatment fell from 55 to 49&emsp14;days (p=0.095). The proportion of patients who felt the diagnostic process took too long fell from 15/80 (19%) to 3/49 (6%) (p<0.05).
  
  
  CONCLUSIONS
  The new pathway led to more effective use of clinic appointments, reduced diagnostic delay, and more rapid treatment decision times. Patient satisfaction with the speed of the diagnostic process increased. It is recommended that hospital trusts in England consider adopting similar 'straight to test' triaging to select patients for lung cancer clinics.
authors.affiliation: Department of Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
authors.forename: Abhimanyu
authors.initials: A
authors.lastname: Lal
authors.forename: Sophie
authors.initials: S
authors.lastname: Phillips
authors.forename: Carolyn
authors.initials: C
authors.lastname: Russell
authors.forename: Ian
authors.initials: I
authors.lastname: Woolhouse
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D006113:United Kingdom; D014850:Waiting Lists; D055815:Young Adult