The introduction of nurse-led telephone clinic for patients on open follow-up
Category: Follow-Up and End-of-Life Care
The problem identified
The lung cancer nurses identified concerns that due to increasing heavy workload; some patients with open follow up become lost in system. Historically for this sub group of patients, emphasis is on the patient to contact the lung cancer nurse service when new symptoms present or if they have new concerns. It was recognised a proportion of individuals for various reasons may not report problems/concerns or seek advice.
The intervention made to change the problem
We introduced various nurse-led telephone clinics; with the aim to capture potential problems early enabling us to ensure appropriate support is put in place at an appropriate time for each patient. The telephone clinics give the patients access to the lung cancer nurses from the comfort of their own home which reduces the burden of hospital visits and is a cost effective method of communicating with and supporting patients.
How it changed my practice
Protected time was introduced for the telephone clinic. A clinic template was set up and a simple proforma has been devised and implemented. One of the nursing team now phones patients on a rotational basis to assess how they are and assess for any new changes/symptoms. A proforma is used to capture data. Patients, as a result of this new intervention, report feeling better supported and as a consequence say they are more likely to contact the lung cancer nursing team with a concern in between telephone reviews. By phone we assess symptoms and advise on the best course of action, aiming for the patient to be managed in the community whenever possible. If necessary we arrange prompt community review; or prompt referral to appropriate specialist services. Alternatively, clinic review can be arranged if patients prefer. With early identification and intervention for new symptoms we believe hospital admissions will be avoided. Telephone follow-up clinics are an efficient way of keeping contact with a large patient group, providing vital support to vulnerable people. The clinics enable us to assess the physical, psychological and social needs of the patient so we can refer the patient onto the appropriate services. The lung cancer nursing team now have better data to evidence time spent speaking to patients.
Resource / Cost implications
Introduction of additional nurse led clinic session. Strong links with community teams required.