Aims:
Efficient and streamlined referral of patients with suspected lung cancer is essential in providing equitable cancer care. As part of evaluating the Townsville Lung Cancer Referral Pathway (TLCRP) implementation, we explored clinicians’ experiences and perspectives about the pathway.
Methods:
This is a descriptive qualitative study nested within a broader implementation science framework. Semi-structured interviews with General Practitioners (GPs) and lung cancer specialists in Townsville Hospital and Health Service (THHS) were conducted. Recruitment continued until data saturation. The interviews were audio-recorded, transcribed and analysed qualitatively using an iterative thematic technique by two researchers.
Results:
Twenty interviews were conducted, 14 with GPs and 6 with specialists, including respiratory physicians and oncologists.
Most GPs use the TLCRP as they found it useful to manage a person suspected with lung cancer and was easily accessible via the relevant website. Fewer GP referrals were rejected if they used the TLCRP. The specialists felt that TLCRP streamlined the lung cancer referral process and encouraged appropriate use of resources. Junior GPs appeared more likely to use the TLCRP compared to senior colleagues. Oncologists reported seeing fewer undiagnosed lung cancer patients after TLCRP implementation.
The common barriers to use of TLCRP were lack of awareness of TLCRP, lack of time to use it and problems encountered with the electronic referral platform. In addition, unwillingness on the part of some GPs to change their referral habit was a barrier to adoption of TLCRP. Many clinicians felt that there should be better integration of GP and specialist care.
Conclusions:
We found most clinicians were satisfied with the web portal and content of the TLCRP and found it useful in the referral process of people with suspected lung cancer. Further measures may have to be taken to reduce barriers in implementing the TLCRP.