There is a paucity of national standard guidelines in Australia for the treatment of lung cancer with regards to time from General Practitioner referral to tertiary centre investigation and management. The South Australian Government guidelines released in September 2013 recommend centres that receive referrals from General Practitioners with probable lung cancer should be aiming to have these patients seen by a lung physician within 14 days of referral.
The Welsh Assembly Government and Department of Health Recommendation, is that a patient be treated by the appropriate lung cancer specialist within 31 days of a decision to treat, and within 62 days of the urgent referral to the specialist care provider..
With the above guidelines in mind, it was felt appropriate for this institution to review its practices in this regard. A chart audit was performed reviewing the referral patterns, investigation, and treatment timeline for the last 100 patients diagnosed with lung cancer and managed at the Gold Coast University Hospital in 2014. A list was generated of lung cancer patients from Queensland Oncology Online (QOOL) database, and an audit was undertaken with a view to improving current patient care and compare local practice and results with national and international standards of care.
Data was obtained from the electronic medical record at the Gold Coast University Hospital, and date of histological diagnosis was confirmed using the pathology computer program AUSLAB. Approval for the audit was obtained via the Human Research Ethics Committee as a Quality Improvement Initiative.
The results revealed interesting data about delays from time from referral to treatment of earlier stage lung cancer, which may require closer scrutiny as these patients have much higher rates of cure from early surgery or definitive radiotherapy. Investigation as an inpatient rather than outpatient led to faster diagnosis and treatment.