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Cutting cancer waiting times: streamlining cervical lymph node biopsy

Published online by Cambridge University Press:  30 September 2013

G Dimbleby ,
L Golding ,
O Al Hamarneh  and
I Ahmad
G Dimbleby*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Birmingham Heartlands Hospital, UK
L Golding
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Birmingham Heartlands Hospital, UK
O Al Hamarneh
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Birmingham Heartlands Hospital, UK
I Ahmad
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Birmingham Heartlands Hospital, UK
*
Address for correspondence: Dr G Dimbleby, Department of Otolaryngology Head and Neck Surgery, Birmingham Heartlands Hospital, Bordesley Green, Birmingham B9 5ST, UK Fax: 0121 424 2200 E-mail: [email protected]
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Abstract

Background:

Patients with enlarged lymph nodes present to a number of different specialties and diagnosis is often made following a biopsy.

Objective:

This study aimed to establish department waiting times for cervical lymph node biopsy, and compare these to the cancer services guidelines.

Methods:

A retrospective audit was carried out to record patient waiting times (defined as the number of days from referral to biopsy) between May and December 2010. A proforma for referral was introduced. In addition, appointments for biopsies were arranged by a co-ordinator. A prospective re-audit was carried out from March to September 2011.

Results:

The first audit showed that national guidelines were not met; there was a median waiting time of 74 days (interquartile range, 47–113). Re-audit demonstrated a significant reduction in waiting times using the proforma; the median waiting time had decreased to 18 days (interquartile range, 9–22).

Conclusion:

A proforma for lymph node biopsy and a designated co-ordinator streamlined the service, significantly reducing waiting times. Together, these can aid referral for meeting guidelines and improve patient care.

Keywords

Head And Neck NeoplasmsLymphomaClinical AuditWaiting ListsLymphadenopathyDiagnosis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 10 , October 2013 , pp. 1007 - 1011
Copyright
Copyright © JLO (1984) Limited 2013 

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Footnotes

Presented as a poster at the Midlands Institute of Otolaryngology, 13 January 2012, Derby, at the Lister Centenary Celebrations at the Royal College of Surgeons of Edinburgh, 9–11 February 2012, Edinburgh, Scotland, and at the 14th British Academic Conference in Otolaryngology and ENT Expo, 4–6 July 2012, Glasgow, Scotland, UK.

References

1The NHS Cancer Plan 27 September 2000. In: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4014513.pdf [28 January 2012]Google Scholar
2Guidance on Cancer Services – Improving Outcomes in Head and Neck Cancer – The Manual. In: http://www.nice.org.uk/nicemedia/live/10897/28851/28851.pdf [28 January 2012]Google Scholar
3Best Practice in Lymphoma Diagnosis and Reporting. In: http://www.bcshguidelines.com/documents/Lymphoma_diagnosis_bcsh_042010.pdf [29 January 2012]Google Scholar
4Khillan, R, Sidhu, G, Axiotis, C, Braverman, AS. Fine needle aspiration (FNA) cytology for diagnosis of cervical lymphadenopathy. Int J Hematol 2012;95:282–4CrossRefGoogle ScholarPubMed
5Howlett, DC, Harper, B, Quante, M, Berresford, A, Morley, M, Grant, J et al. Diagnostic adequacy and accuracy of fine needle aspiration cytology in neck lump assessment: results from a regional cancer network over a one year period. J Laryngol Otol 2007;121:571–9CrossRefGoogle ScholarPubMed
6Khanna, R, Sharma, AD, Khanna, S, Kumar, M, Shukla, RC. Usefulness of ultrasonography for the evaluation of cervical lymphadenopathy. World J Surg Oncol 2011;28:29Google Scholar
7Gupta, A, Rahman, K, Shahid, M, Kumar, A, Qaseem, SM, Hassan, SA et al. Sonographic assessment of cervical lymphadenopathy: role of high-resolution and color Doppler imaging. Head Neck 2011;33:297–302CrossRefGoogle ScholarPubMed