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Published byJoshua Tate Modified over 9 years ago
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Improving diagnostic services for patients attending Outpatient Thyroid clinics Mr Vijay Kurup Consultant Surgeon Karen Milburn Specialist Nurse Lynn Armstrong OPD Matron
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Background Thyroid service integral part of North of England Cancer Network Weekly thyroid outpatient clinic Dedicated Team providing diagnostic and treatment service for thyroid cancer.
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Reason for improvement FNAC is the main diagnostic procedure. Fine needle biopsy performed free hand, by all grades in outpatient clinic. Inadequate sample main problem.. (THY1). FNA needs frequently repeated.
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Observation & Develop a New Vision DO ACT PLAN CHECK Awareness- A Change In Practice Clinical Audit Plan a change in service Give it a try DO ACT PLAN STUDY Study the results
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New measures US guided FNAC by one dedicated radiologist. Analysis of specimen by one dedicated pathologist.
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Difficulties Discussions with Clinical directors&managers Any willing radiologist? Funding issues. Sessional committment from radiologist/CD radiology to meet time limits/targets
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Solutions One radiologist agreed. Funding was never agreed;but happened. One pathologist agreed. Now every FNA is done with the help of US guidance by dedicated radiologist. Our FNA accuracy is now better than national average.
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THY1 Audit Results Before improvement THY1 rate = 52.1% One year After Improvement THY1 rate = 30.2%(Re audit) Currently about 20%
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Conclusion Revised diagnostic sampling procedure successful Commitment and support for its implementation Recommendation…. A One Stop clinic for patients
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