Aims: To improve appropriate and timely referral and diagnosis by identifying best-practice diagnostic and referral pathways for lung cancer, to facilitate and support the local implementation and evaluation of the national Optimal Care Pathway across NSW.
Methods: Develop a toolkit for the mapping, development and dissemination of localised lung cancer referral and diagnostic pathways at two local health district (LHD) pilot sites. Following a literature review of lung cancer pathway implementation and evaluation, best-practice lung cancer diagnosis and referral pathways were identified. A priority setting workshop was held to gain consensus on pathway and implementation options for toolkit design. In collaboration with the Cancer System Innovation Managers (CSIMs) Community of Practice (CoP) and pilot sites, the toolkit including; mapping methodology, audit tools, qualitative interviews, and an implementation strategy were piloted over six-months. The evaluation measured pilot site’s experience and outcomes of mapping and developing pathways.
Results: This project delivered a framework and toolkit for mapping, developing and disseminating the localised lung cancer Optimal Care Pathway, which was endorsed and implemented by the Cancer Institute NSW. Pilot and non-pilot sites reported that peer engagement though the CSIM CoP provided opportunity to share challenges and solutions to project management, data access, medical audits, and stakeholder engagement. Both sites reported that early engagement of clinicians and GP liaisons was advantageous to change management and pathway dissemination. Surveys captured that Respiratory Physicians acted as champions and an active presence in the MDT was critical project success. Both pilot sites strengthened their partnerships with Primary Healthcare Networks.
Conclusion: The Toolkit provides a valuable resource for CSIMs seeking to improve the patient experience and outcomes. This project contributed to the generation of localised referral and diagnosis pathways in LHDs. It is recommended that services without defined cancer care pathways replicate the pathway development using the Toolkit.