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RAPID项目的实施与成果:解决曼彻斯特肺癌诊疗路径的前端问题

Implementation and outcomes of the RAPID programme: Addressing the front end of the lung cancer pathway in Manchester.

作者信息

Evison Matthew, Hewitt Kath, Lyons Judith, Crosbie Phil, Balata Haval, Gee Caroline, Duerden Rebecca, Greaves Melanie, Sharman Anna, Booton Richard

机构信息

Wythenshawe Hospital, Manchester, UK

Wythenshawe Hospital, Manchester, UK.

出版信息

Clin Med (Lond). 2020 Jul;20(4):401-405. doi: 10.7861/clinmed.2019-0218.

Abstract

INTRODUCTION

Patients with suspected lung cancer require computed tomography (CT), specialist interpretation of the CT and a consultation with a specialist. Significant time savings could be made with rapid access to these components in the front end of the lung cancer pathway.

METHODS

The RAPID programme was launched at Manchester's Wythenshawe Hospital in April 2016. This pathway offers next working day CT for patients with suspected lung cancer, immediate 'hot' reporting of CT images and a same day consultation with a diagnostic specialist.

RESULTS

From April 2016 to January 2019, 1,027 patients were referred to the RAPID programme. The median time from referral to CT was 3 days. The CT was hot reported in 94% of patients. The median time from CT to triage and consultation with a diagnostic specialist was 0 days. Overall 56% and 90% of patients had completed a CT and consultation within 3 and 7 days of referral, respectively (0% and 24% prior to implementation).

CONCLUSION

Through simple reorganisation of workload, we have significantly reduced the pathway for patients with suspected lung cancer to meet a specialist with a reported CT, something we firmly believe is replicable across all hospitals.

摘要

引言

疑似肺癌患者需要进行计算机断层扫描(CT)、由专家解读CT结果并与专科医生进行会诊。如果在肺癌诊疗流程的前端能够快速获取这些环节的服务,可大幅节省时间。

方法

2016年4月,曼彻斯特怀森肖医院启动了RAPID项目。该流程为疑似肺癌患者提供下一个工作日的CT检查、CT图像的即时“加急”报告以及与诊断专科医生的当日会诊。

结果

2016年4月至2019年1月,共有1027名患者被转诊至RAPID项目。从转诊到进行CT检查的中位时间为3天。94%的患者的CT检查报告为加急。从CT检查到分诊以及与诊断专科医生会诊的中位时间为0天。总体而言,分别有56%和90%的患者在转诊后的3天和7天内完成了CT检查和会诊(实施前分别为0%和24%)。

结论

通过简单的工作量重新安排,我们显著缩短了疑似肺癌患者获得有报告的CT检查并见到专科医生的流程,我们坚信这一做法在所有医院都可推广。

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