Implementing A One-Day Testing Model Improves Timeliness of Workup for Patients with Lung Cancer

Background: Patients with lung cancer often experience stressful delays throughout the diagnostic phase of care. To address that situation, our multidisciplinary team created a “Navigation Day,” during which patients partake in a single-day visit that comprises nurse-led teaching, social work, smoking cessation counselling, symptom control, and dedicated test slots for integrated positron-emission tomography and computed tomography (PET/CT), pulmonary function tests (PFTS), and magnetic resonance imaging (MRI) of the brain. We evaluated the effects of that program on wait times and patient satisfaction. Methods: Patients with a suspicion of lung cancer on chest ct imaging referred during 3 time periods were reviewed: 1 year before launch of the Navigation Day, 1 year post-launch, and 2 years post-launch. Patients were further stratified according to concordance of their test date with a Navigation Day date. Mean wait times for PET/CT, PFTS, and MRI brain were calculated for each group. Patient satisfaction was measured using a standardized provincial survey. The Student t-test and analysis of variance were used to assess for significance. Results: After implementation, mean wait times in the first year improved to 9.2 days from 15.5 days for PET/CT (p < 0.0001), to 9.6 days from 15.7 days for PFTS (p < 0.0001), and to 10.2 days from 16.0 days for MRI brain (p < 0.0001). Patients who used a dedicated test slot experienced the shortest wait times, at 5.8 days for PET/CT, 5.8 days for pfts, and 6.3 days for mri brain (p < 0.0001). Those improvements were sustained at 2 years post-launch. Conclusions: Patient satisfaction in the categories of assistance, emotional support, and clarity remained high post-launch. Navigation Day significantly improved the timeliness of diagnostic testing services in patients with suspected lung cancer.