Dr Louise Brown North Manchester General Hospital Clinical Lead for Lung Cancer NE Sector What is Prehab What is Prehab Lung Surgical Pathway Lung Surgical Pathway Surgical risk 2 mortality rate ID: 913147
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Slide1
Developing the Prehab Pathway for Lung Cancer Patients
Dr Louise BrownNorth Manchester General HospitalClinical Lead for Lung Cancer, NE Sector
Slide2What is Prehab ?
Slide3What is Prehab ?
Slide4Slide5Lung Surgical Pathway
Slide6Lung Surgical Pathway
Slide7Surgical risk
2%
mortality rate
at 90 day30 day complication rate is 30%
More frail 50-60% complications
Slide8Levels of support
Universal Targeted
Model
Slide9Local challenges for NE Sector:deprivation, frailty
Unemploymentlack of transportNo access to shuttlewalk or 6 minute walk assessments Cultural and language barriers
Lung Prehab Subgroup
Slide10Total Patients Assessed
71
ISWT Score
Total
%
ISWT < 250
52
73.2
ISWT 250-390
8
11.3
ISWT >= 400
10
14.1
Patients employed
7
9.9
Patients not employed
64
90.1
Patients meeting AOT criteria
8
11.3
North Manchester pilot
Patients confirmed lung cancer = 24:
Referred for surgery: 10
Range: 130 – 260m
Mean: 175m
1 patient >250m
Referred for radical intent oncology treatment: 6Range: 40 – 380mMean: 182m1 patient > 250m
(January – March 2019)
Slide11Slide12Creating a Standardised operating policyCompetency assessments for Band 4’s
Support from experienced respiratory physiotherapistFinding a suitable environmentSharing best practiceIncorporating other health and well being assessments to ensure all modifiable risk factors are addressed
Embedding a new service
Slide13Slide14All surgical referrals:Shuttlewalk
assessment when they attend clinicAim to refer all patients for prehab and actively encourage patients to engage with the teams (including surgery school)Patients with <250m are still referred as long as no cardiovascular risk factors and clinical teams agree appropriateIncorporate tobacco addiction and referral for treatment if needed
Continuing to develop/improve the service
Current practice: