Developing a Pulmonary Nodule Service: Outcomes, Challenges and Future Aspirations

<bold>Introduction:</bold> In November 2022 we developed a dedicated incidental pulmonary nodule (IPN) service, led by two specialist lung nodule navigators working alongside respiratory physicians and thoracic radiologists. This project was funded by the Thames Valley Cancer Alliance, identifying IPN services as a regional risk. Data presented after 6 months of the project showed significant improvements in patient management and timely investigation for growing nodules,(BTOG 2023). Here we present further developments and improvements made. <bold>Methods:</bold> We prospectively recorded service performance metrics and compared them to pre- service. Costings were calculated using 2022/2023 tariffs. <bold>Results:</bold> Table 1 compares outcomes pre and post October 2022, showing: · Reduction in time from CT scan reporting to patient communication. · Increase in patients discharged at point of referral using navigator-obtained volumetry measurements and retrospective cross-sectional imaging analysis. · Cost benefits of the service, including an approximate cost saving of approximately £174 000/annum from moving from a Consultant- led to Specialist Nurse led service. Furthermore, we have: · Improved patient safety proactively reviewing all CT scans reporting a pulmonary nodule. · Created a standardised electronic patient referral pathway within the Trust and in primary care. · Created a bespoke teaching package for clinicians managing IPNs <bold>Conclusions:</bold> Our future work involves training our navigators to act as first readers for CT scans, report volumetry and to conduct face to face patient assessment. This work is supervised by respiratory physicians and radiologists and demonstratates that multdisciplinary collaboration improves patient outcomes.