Cutting cancer waiting times: streamlining cervical lymph node biopsy.
BACKGROUND
Patients with enlarged lymph nodes present to a number of different specialties and diagnosis is often made following a biopsy.


OBJECTIVE
This study aimed to establish department waiting times for cervical lymph node biopsy, and compare these to the cancer services guidelines.


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Department of Otolaryngology Head and Neck Surgery, Birmingham Heartlands Hospital, UK.
G
G
Dimbleby
L
L
Golding
O
O
Al Hamarneh
I
I
Ahmad
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D054869:Clinical Audit; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000601:surgery; D008223:Lymphoma / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors; D014850:Waiting Lists; D055815:Young Adult