P163 Outcomes from a novel nurse led telephone clinic post thoracic surgery

Abstract

Introduction: Moore et al. reported that nurse led initiatives can reconfigure care, making it more responsive to individual needs, increasing patient satisfaction and reducing hospital visits. Nurse-led telephone clinics, post-surgery, have evidence of patient satisfaction and reduction in post-op complications. York Trust patients are discharged after thoracic surgery with a surgical outpatient appointment at 6 weeks and no routine community follow up. These patients often undergo complicated surgery, and are discharged with chest drains and strong opioids. Methods: All patients discharged after surgery were contacted by telephone up to a maximum of a week after discharge with a further follow up call 2 weeks later if needed. A protocol of open questions was used to identify post-op difficulties at an early stage, facilitate referrals & improve patient experience. Results: 29 patients were contacted over a 6 month period, following discharge after thoracic surgery; VATs, lobectomy, sleeve/wedge resection, pneumonectomy and pleurectomy. Each call lasted up to 20 minutes, equating to a maximum 10 hours of nurse time. Telephone clinic highlighted a number of medical issues that required intervention preventing GP and hospital appointments/admissions. Commonly reported symptoms included pain, shortness of breath, fatigue, constipation, weight loss and inability to sleep. In most cases simple advice and reassurance could be given. In 3 cases, medication was organised. A referral to the GP or community services was organised in 4 cases. Conclusion: This study supports a report by Roy Castle Lung Cancer Foundation (2013). This illustrated that Lung CNS's can increase productivity and efficiency by intervening to manage lung cancer treatment side effects and symptoms, preventing costly unplanned hospital admissions. They can also provide nurse-led services that free up consultant resource, and empower patients with lung cancer to self-manage their condition, leading to additional efficiency savings.