50 Background: Timeliness of care in patients with newly diagnosed lung cancer is a controversial topic. Although some studies have concluded that timeliness does not improve clinical outcomes, many experts agree that timeliness is an important aspect of quality care as it leads to shorter duration of emotional distress during the diagnostic process and treatment initiation. Methods: At the LSVAMC, we have established a 60-day time interval from first abnormal radiology to treatment initiation as our institutional standard of care. We have initiated several interventions to improve timeliness of care through our new lung cancer program launched in July 2012. These interventions, which were implemented over a 1 year period, include: 1) Weekly interdisciplinary lung nodule rounds. 2) A cancer care tracking system. 3) A lung cancer-specific case manager who collaborates with all disciplines to expedite workup and treatment initiation. We have retrospectively reviewed all NSCLC cases since the launch of the new lung cancer program (group 1) and compared the timeliness to a sample of patients before the interventions (group 2). Results: 58 patients (group 1) and 107 patients ( group 2) with NSCLC were diagnosed and treated at the LSVAMC from January to July 2011 and July 2012 to May 2013 respectively. Median time from first abnormal radiology to first treatment was 104 days (range 13-375, mean 113.4) in group 1 and 81 days (range 1-261, mean 84.9) in group 2. Median time from diagnostic radiology to tissue diagnosis was 39 days (range 2-226, mean 66) in group 1 and 29 days (range 2-206, mean 42.6) in group 2. Median time from tissue diagnosis to first treatment was 23 days (range 0-177, mean 38) in group 1 and 28 days (range 0-254, mean 36.5) in group 2. Conclusions: Timeliness of care in NSCLC patients at our center has improved. We still have not reached our target. Continued progress is expected as we transition to a multidisciplinary multi specialty care lung cancer program.
A Multidisciplinary Lung Cancer Program: Does It Reduce Delay Between Diagnosis and Treatment?