Developing a Fast Track Lung Cancer System to Improve Patient Safety by Expediting Diagnosis, Follow-Up and Treatment

Missed or delayed cancer diagnoses are a frequent cause of patient harm and malpractice lawsuits in the ambulatory setting. Several domains have been identified that contribute to preventable delays in diagnosis, ranging from system factors (such as delays in obtaining appointments) to physician and patient factors. A study of closed malpractice claims revealed that 59 percent of cases involved diagnostic errors that harmed patients. The most common breakdowns in the diagnostic process were failure to order an appropriate diagnostic test, failure to create a proper follow-up plan, failure to obtain an adequate history or perform an adequate physical examination and incorrect interpretation of diagnostic tests. The leading factors that contributed to errors were failures in judgment; lack of vigilance, memory or knowledge; patient-related factors; and handoffs. By providing timely care along the continuum of lung cancer care, providers may limit the disease progression and improve clinical outcomes. Lincoln Medical and Mental Health Center created the Fast Track Intervention System to expedite time from suspicious imaging to diagnosis, diagnosis to treatment, and overall cycle time. It also streamlines and facilitates patient follow-up, and improves communication, handoffs and teamwork.