Evaluating the impact of the cancer diagnostic clinic: A two-year update on timely access, diagnosis, and treatment.

152 Background: We present a two-year update on the Cancer Diagnostic (CDx) clinic, which evolved from a pilot feasibility project into a sustainable, system-level intervention at the University of Pennsylvania Health System (UPHS). Designed to expedite the diagnostic workup for patients with suspected cancer, streamline testing, and ensure timely transition to subspecialty oncology care, we aimed to improve patient experience and cancer-related outcomes. Integrated into existing clinician panels, the clinic is staffed by medical oncologists, fellows, NP, oncology nurse navigator, RN, and LCSW. Through a phased referral rollout and iterative process improvements, the clinic expanded access, increased referrals, and maintained efficient time intervals from initial visit to diagnosis and treatment. Methods: The QI initiative began as a phased pilot in March 2022 and, following early improvements in system throughput, was formalized as a permanent UPHS program. This report presents data from March 2023 to March 2025. Referrals, both external and internal, were introduced over seven Plan-Do-Study-Act cycles, including 4 EDs, 24 Hospital Medicine teams across four sites, a PM&R team, and UPHS PCPs plus 27 county PCP networks. Epic referrals were submitted via an “Oncology Nurse Navigator Services” order, later transitioned to a dedicated “Consult to Cancer Diagnostic Clinic” order. Outcomes included referral volume, new patient visits (NPVs), time from referral to NPV, time from NPV to tissue-confirmed diagnosis and first cancer-directed treatment, Vizient length of stay (LOS), cancer type, and UPHS retention. Statistical process control charts tracked trends. Results: During the study period, 834 referrals resulted in 241 patients seen in clinic, averaging 9 NPVs/month. Median time from referral to NPV, diagnosis, and treatment was 6, 8, and 31 days, respectively—improved from baseline intervals of 7, 21, and 42 days. Vizient LOS declined from 8 to 4 days, and the observed-to-expected ratio improved from 1.27 to 0.78. New cancer was diagnosed in 63.1% (n = 152), most commonly GI (36.8%, n = 56), thoracic (22.4%, n = 34), and hematologic (19.1%, n = 29) malignancies. Two patients enrolled on a therapeutic clinical trial, and 97.7% remained in UPHS for ongoing care. Conclusions: By leveraging a multidisciplinary team, the CDx clinic streamlines referrals and improves timely access while reducing time to diagnosis and initiation of cancer-directed therapy. The clinic continues to expand and refine referral pathways—redirecting diagnostic efforts to coordinated, oncologist-led outpatient evaluation, reducing unnecessary admissions, and shortening LOS. This adaptable, team-based model offers a scalable framework for institutions seeking to reprioritize resources and improve cancer care coordination, diagnostic efficiency, and outcomes across a multifaceted care continuum.