Using clinical audit, qualitative data from patients and feedback from general practitioners to decrease delay in the...

Area of Science:

• Oncology
• Health Services Research
• Patient Experience

Background:

• Local concerns identified potential delays in diagnosing and referring patients with suspected colorectal cancer.
• Understanding patient experiences of diagnosis and referral is crucial for improving care pathways.

Purpose of the Study:

• To identify referral delays for suspected colorectal cancer using clinical audit and patient feedback.
• To reduce these delays by implementing evidence-based referral guidelines and improving communication.

Main Methods:

• Audit of endoscopy referrals, including rectal examination documentation and waiting times.
• Qualitative interviews with 19 patients regarding their referral and diagnosis experiences.
• Review of 33 case records to identify additional potential delays.

Main Results:

• Most patients (67%) were seen within two weeks, but only 47% of referrals mentioned rectal examination.
• Patients perceived delays primarily in secondary care, often after non-urgent referrals.
• Identified issues with communication, information, and support for patients post-diagnosis.

Conclusions:

• Combining audit data with patient qualitative feedback effectively prompted action on hospital referral delays.
• Average waiting times decreased significantly following guideline implementation and national focus.
• GP feedback aided pro forma development, but monitoring waiting times overshadowed other evaluations; patient support initiatives need refinement.