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. 2020 Jul;20(4):401-405.
doi: 10.7861/clinmed.2019-0218.

Implementation and outcomes of the RAPID programme: Addressing the front end of the lung cancer pathway in Manchester

Matthew Evison  1 , Kath Hewitt  2 , Judith Lyons  2 , Phil Crosbie  2 , Haval Balata  2 , Caroline Gee  2 , Rebecca Duerden  2 , Melanie Greaves  2 , Anna Sharman  2 , Richard Booton  2
Affiliations

Implementation and outcomes of the RAPID programme: Addressing the front end of the lung cancer pathway in Manchester

Matthew Evison et al. Clin Med (Lond). 2020 Jul.

Abstract

Introduction: Patients with suspected lung cancer require computed tomography (CT), specialist interpretation of the CT and a consultation with a specialist. Significant time savings could be made with rapid access to these components in the front end of the lung cancer pathway.

Methods: The RAPID programme was launched at Manchester's Wythenshawe Hospital in April 2016. This pathway offers next working day CT for patients with suspected lung cancer, immediate 'hot' reporting of CT images and a same day consultation with a diagnostic specialist.

Results: From April 2016 to January 2019, 1,027 patients were referred to the RAPID programme. The median time from referral to CT was 3 days. The CT was hot reported in 94% of patients. The median time from CT to triage and consultation with a diagnostic specialist was 0 days. Overall 56% and 90% of patients had completed a CT and consultation within 3 and 7 days of referral, respectively (0% and 24% prior to implementation).

Conclusion: Through simple reorganisation of workload, we have significantly reduced the pathway for patients with suspected lung cancer to meet a specialist with a reported CT, something we firmly believe is replicable across all hospitals.

Keywords: Lung cancer; RAPID programme; pathway.

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Figures

Fig 1.
Fig 1.
Radiology vetting process for type of computed tomography performed in the RAPID programme. CT = computed tomography; CXR = chest X-ray; GI = gastrointestinal.
Fig 2.
Fig 2.
Overview of the RAPID programme outcomes. The RAPID pathway, 1,027 patients from April 2016 – January 2019. CT = computed tomography.
Fig 3.
Fig 3.
Average time for all non-RAPID requests of computed tomography of the thorax from 2015 to 2019. a) Time from computed tomography request to computed tomography is performed. b) Time from computed tomography is performed to reporting.
Fig 4.
Fig 4.
Volume of 2-week wait for suspected lung cancer referrals from 2015 to 2018.
See this image and copyright information in PMC

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