2016 Cancer Annual Report | Page 16

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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