Abstract 287P
Background
Optimal care pathway (OCP) highlights the importance of timeliness to care, stipulating specific timepoints that each component of care must be delivered within. RALLC is an example of a service delivery model that has been adopted widely to improve timeliness to care, but lacks any published standardized framework in Australia, which is reflected in a wide variety of clinics being called RALLC. Here we describe the RALLC model that we implemented in 2017 and present our long-term timeliness and clinical outcome data.
Methods
Pre- (2015–16) and post-RALLC (Jul ‘17 – Dec ‘21) data were collected retrospectively, including demographics, OCP timeframes, and clinical outcomes (event free survival for stage I-III, and progression free survival-1 for stage IV disease) and analyzed using descriptive and multivariate analysis.
Results
The RALLC team includes lung coordinator, medical oncologist, respiratory physician and thoracic surgeon, running weekly clinic. A centralized referral pathway and referral criteria is utilized, with referrals triaged by an oncologist. Preemptive investigations are organized prior to a patient’s first clinic appointment, to maximize relevant clinical information available at first visit where consultation with all relevant sub-specialties occur on the same day. During the study period, 266 patients (53% male, 58% stage I–III, 86% ECOG 0–1) were diagnosed with lung cancer through RALLC, compared with 36 historical controls (55% male, 31% stage I–III, 76% ECOG 0–1). Mean time from referral to first appointment, referral to diagnosis and referral to treatment commencement were 7.5, 20 and 45-days, respectively since implementation of RALLC, compared to 11, 35.5 and 62-days, pre-RALLC. Survival probability combined for all patients improved numerically since RALLC (HR 0.68, p-value 0.15), but most significantly for early-stage patients (HR 0.55, p-value 0.002).
Conclusions
This RALLC model incorporates a multidisciplinary team and a preemptive investigative approach, expediting diagnosis and treatment. Rapid diagnostic pathway also improves treatment outcome for patients, at least in the early-stage setting.
Legal entity responsible for the study
Grampians Health.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.