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130 Retrospective audit of 2 Week Wait (2WW) clinic patient information leaflet
Poster abstracts, 12th Annual British Thoracic Oncology Group Conference, 2014: Other related to the cancer but not a consequence of progressive disease. Following admission, 86% were discharged home, 6% went to the hospice and 8% died during the acute episode. Of note, 40% were discharged within 72 hours of admission. Conclusion: The AOS is appropriately identifying patients admitted with problems directly related to treatment or progression of their lung cancer; 48% of the patients in this analysis. This has resulted in improved quality of care, appropriate changes in management and reduced hospital LOS. However, as in the previous analysis, onethird of admissions were a direct consequence of cancer, but not of disease progression. Planning to avoid these admissions has included development of an ultrasound-guided pleural aspiration service, facilities for urgent outpatient reviews and emphasis on provision of information and advice to patients, families and caregivers. 129 Fibreoptic bronchoscopic electrocautery for palliation in patients with central lung cancer S. Adlakha *, D. Baldwin. City Hospital, Hucknall Road, Nottingham, NG5 1PB, UK Introduction: Endobronchial obstruction in lung cancer can be a significant cause of morbidity by causing breathlessness form loss of lung function, chest pain from lung collapse and by causing post-obstructive pneumonia. Electrocautery is done under conscious sedation using readily available equipment, requiring little in the way of capital outlay. It can provide rapid palliation and symptomatic relief but patient selection is key. In this report we review the outcome of the procedure done for lung malignancies in our hands. Method: A retrospective review of records of patients who had the procedure from June 2006 until July 2013 was undertaken. Details of the indication for the procedure and outcome were recorded. Results: Twenty-two patients had the procedure done for palliation of endobronchial malignancy (other indications were persistent haemoptysis) and three had more than one procedure. Patients were aged between 47 to 89 years (median 67). Fifteen patients (68%) reported a subjective improvement in their symptoms. Haemoptysis resolved in four patients. Eleven patients reported improvement in their dyspnoea. Seven (32%) patients reported no symptomatic improvement. The underlying diagnosis was lung cancer in 15 patients, renal metastasis in 3 patients and thyroid, stromal sarcoma of uterus, colorectal cancer and mesothelioma (1 patient each). There were no deaths and no complications related to procedure. All patients were discharged the same day from hospital. Conclusion: Fibreoptic bronchoscopic electrocautery, as one of the recommended forms of endobronchial therapy by the National Institute of Clinical and Care Excellence (NICE), can be expected to produce a favourable subjective improvement in two thirds of patients. The procedure is well tolerated and relative free from complications. The procedure is probably under-used and should be more widely available to patients who are symptomatic from central airway tumours.
(A)
(B)
Figure: (A) Before and (B) after electrocautery.
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130 Retrospective audit of 2 Week Wait (2WW) clinic patient information leaflet J. Barfoot1 *, A. Pawlowicz2 . 1 Lung Cancer Advanced Nurse Practitioner, 2 Consultant Respiratory Physician, The Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, UK Introduction: The lung cancer team felt it would be of benefit for patients to receive an information leaflet prior to their appointment in the fast track 2 week wait (2WW) lung cancer clinics. Dr Anna Pawlowicz produced a “2Week Wait (2WW) chest clinic” patient information leaflet which explains why the patient might be referred to the clinic, what will happen at their first clinic appointment and at subsequent clinic visits. The leaflet was approved by Readers Panel in August 2012. Method: A retrospective audit was carried out to ascertain if patients were sent the information leaflet with their appointment letter and if they felt it was of benefit to them. 10 patients were randomly selected from each 2WW clinic (coded QAPOC, QAKAOC, QSDROC). The patients were asked to complete an audit questionnaire of just 4 questions (table). Table: Questions and results Question
Response
Compliance
Total Yes No 1. Did you receive a 2WW chest clinic leaflet with your hospital appointment letter? 2. Was it easy to understand? 3. Was it helpful? 4. Is there anything else that could be added to this leaflet to make it more helpful? If yes please write in box below
30
27
3
90%
27 27 30
27 27 0
0 100% 0 100% 30 100%
1. 90% of patients were sent the 2WW clinic patient information leaflet. 2. 100% of patients who were sent the information leaflet found it helpful and 100% of these said there was nothing else to add. 3. 3 patients out of 30 (10%) who were not sent the 2WW patient information leaflet but were given the leaflet with the questionnaire all 3 (100%) said there was nothing else to add and 2 of these commented they would have found it useful to receive pre clinic. Recommendation: This audit showed that provision of an information leaflet sent prior to the patients attending the lung cancer 2WW fast track clinic explaining what will happen when they attend is good medical practice and improves the quality of patient experience. 131 Preferred place of care in thoracic cancer patients within the palliative care service covering South Ribble, Preston and Chorley R. Knight *, A.G. Sutherland, E. Shereston, A. Parr, L. Forman, A. McCann. St Catherine’s Hospice, Leyland Lancashire, UK Introduction: The patients Preferred Place of Care (PPC) is an important target for any health care team looking after people in the terminal phase of their life. This audit looked at the achievement of PPC in patients with a diagnosis of intra-thoracic malignancies within the boroughs of Chorley, Preston and South Ribble, catchment area of St. Catherine’s Hospice, Preston. Methods: Palliative Care teams in this area utilize the ‘SystmOne’ electronic patient record. A search was completed between 01.01.2012 and 01.01.2013 looking at deaths linked to intra-thoracic malignancy (Table 1), date of death, organisation, department, PPC and actual place of death were searched. Results: • 109 patients identified. • 37 (34%) died within the Acute Hospital setting
(A)
(B)
Figure: (A) Before and (B) after electrocautery.
S47
130 Retrospective audit of 2 Week Wait (2WW) clinic patient information leaflet J. Barfoot1 *, A. Pawlowicz2 . 1 Lung Cancer Advanced Nurse Practitioner, 2 Consultant Respiratory Physician, The Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, UK Introduction: The lung cancer team felt it would be of benefit for patients to receive an information leaflet prior to their appointment in the fast track 2 week wait (2WW) lung cancer clinics. Dr Anna Pawlowicz produced a “2Week Wait (2WW) chest clinic” patient information leaflet which explains why the patient might be referred to the clinic, what will happen at their first clinic appointment and at subsequent clinic visits. The leaflet was approved by Readers Panel in August 2012. Method: A retrospective audit was carried out to ascertain if patients were sent the information leaflet with their appointment letter and if they felt it was of benefit to them. 10 patients were randomly selected from each 2WW clinic (coded QAPOC, QAKAOC, QSDROC). The patients were asked to complete an audit questionnaire of just 4 questions (table). Table: Questions and results Question
Response
Compliance
Total Yes No 1. Did you receive a 2WW chest clinic leaflet with your hospital appointment letter? 2. Was it easy to understand? 3. Was it helpful? 4. Is there anything else that could be added to this leaflet to make it more helpful? If yes please write in box below
30
27
3
90%
27 27 30
27 27 0
0 100% 0 100% 30 100%
1. 90% of patients were sent the 2WW clinic patient information leaflet. 2. 100% of patients who were sent the information leaflet found it helpful and 100% of these said there was nothing else to add. 3. 3 patients out of 30 (10%) who were not sent the 2WW patient information leaflet but were given the leaflet with the questionnaire all 3 (100%) said there was nothing else to add and 2 of these commented they would have found it useful to receive pre clinic. Recommendation: This audit showed that provision of an information leaflet sent prior to the patients attending the lung cancer 2WW fast track clinic explaining what will happen when they attend is good medical practice and improves the quality of patient experience. 131 Preferred place of care in thoracic cancer patients within the palliative care service covering South Ribble, Preston and Chorley R. Knight *, A.G. Sutherland, E. Shereston, A. Parr, L. Forman, A. McCann. St Catherine’s Hospice, Leyland Lancashire, UK Introduction: The patients Preferred Place of Care (PPC) is an important target for any health care team looking after people in the terminal phase of their life. This audit looked at the achievement of PPC in patients with a diagnosis of intra-thoracic malignancies within the boroughs of Chorley, Preston and South Ribble, catchment area of St. Catherine’s Hospice, Preston. Methods: Palliative Care teams in this area utilize the ‘SystmOne’ electronic patient record. A search was completed between 01.01.2012 and 01.01.2013 looking at deaths linked to intra-thoracic malignancy (Table 1), date of death, organisation, department, PPC and actual place of death were searched. Results: • 109 patients identified. • 37 (34%) died within the Acute Hospital setting