Time to Treatment in Advanced Lung Cancer: A Quality Improvement Project Using Nurse Navigation and Liquid Biopsy

晚期肺癌治疗时间:一项利用护士导航和液体活检的质量改进项目

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Abstract

BACKGROUND: Newly diagnosed patients with lung cancer experience significant challenges navigating a fragmented health system. Nurse navigators can use clinical expertise and coordination to address barriers to care. OBJECTIVES: This quality improvement project aimed to expedite the selection and initiation of first-line treatment for patients with stage III or IV lung cancer. Using a nurse navigator process early on in care, coupled with liquid biopsy, this project focused on reducing the time from tissue biopsy to treatment decision. METHODS: The team performed a retrospective chart review 12 months preimplementation and 8 months postimplementation. FINDINGS: Using liquid biopsy, the time to treatment initiation was 21 days compared to 36 days with tissue biopsy only (p = 0.003). Postimplementation, median days to treatment decreased from 34 to 23.5 (p = 0.027), and treatment decisions made during the initial medical oncology visit increased from 38% to 55%.

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