TY - JOUR T1 - Managing patient pathways to achieve lung cancer waiting time targets: Mixed method study JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - 4672 AU - Hugh Ip AU - Tarik Amer AU - Michael Dangoor AU - Affan Zamir AU - Darryl Gibbings-Isaac AU - Ranjeev Kochhar AU - Timothy Heymann Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/4672.abstract N2 - Background: England's NHS introduced a 62-day target, from referral to treatment, to make lung cancer patient pathways more efficient. This study aims to understand pathway delays that lead to breaches of the target when patients need care in both secondary and tertiary setting so more than one institution is involved.Methods: Mixed method cross case analysis. Qualitative methods include pathway mapping and semi-structured interviews. Quantitative analysis of patient pathway times from cancer services records.Setting: Two tertiary referral hospitals in LondonParticipants: Database records of 53 patients were analysed. 19 sets of patient notes were used for pathway mapping. 17 doctors, 4 nurses, 8 managers and administrators were interviewed.Results: The majority of the patient pathway (68.4%) is spent in secondary centres. There is more variability in the processes of secondary centres but tertiary centres do not have perfect processes either.Three themes emerged from discussions: information flows, pathway performance, and the role of the multidisciplinary approach.Conclusions: The actions of secondary centres have a greater influence on whether a patient breaches the 62-day target, compared to tertiary centres. Nevertheless variability exists in both, with potential for improvement. ER -