BAUS 2015

Putting clinical assessment and patient experience at the centre of prostate cancer diagnostics: The superior prostate experience and efficient diagnostics (SPEED) pathway
BAUS ePoster online library. Withington J. 06/21/21; 318989; p1-10 Disclosure(s): NIl
Mr. John Withington
Mr. John Withington
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Abstract
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Background 
A barrier to swift prostate cancer (PC) diagnosis is the high volume of referrals, many of which present with benign symptoms. Achieving pathway efficiency has popularised straight to test 'MRI', which although attractive is expensive and ultimately unnecessary for all.

Robust medical management of prostate patients requires a history, examination, urinary assessment and symptom management to mitigate for over-investigation and biopsy complications; infection, acute retention. We used Experience Based Co-Design to design a PC diagnostic service, combining clinical excellence with resource efficiency in the SPEED (Superior Prostate Experience and Efficient Diagnostics)Pathway.

Methods 
We compared the RAPID (Rapid access prostate imaging and diagnosis) Pathway with SPEED. Comparison was made to; MRI usage, referral to MRI, and yield of clinically significant PC.
All SPEED patients were invited to complete a patient experience survey and thematic analysis was conducted.

Results 
(See table)
Analysis of patient experiences identified key themes that enhanced patient experience; robust clinical review, pathway coordination and supportive care.

Conclusion 
MRI pre-biopsy is poor corporate governance of a valuable resource. Effective clinical triage of patients makes most efficient use of MRI and enables assessment and management of presenting symptoms to run in parallel with a PC diagnosis. Patients appear highly satisfied with this approach.
Background 
A barrier to swift prostate cancer (PC) diagnosis is the high volume of referrals, many of which present with benign symptoms. Achieving pathway efficiency has popularised straight to test 'MRI', which although attractive is expensive and ultimately unnecessary for all.

Robust medical management of prostate patients requires a history, examination, urinary assessment and symptom management to mitigate for over-investigation and biopsy complications; infection, acute retention. We used Experience Based Co-Design to design a PC diagnostic service, combining clinical excellence with resource efficiency in the SPEED (Superior Prostate Experience and Efficient Diagnostics)Pathway.

Methods 
We compared the RAPID (Rapid access prostate imaging and diagnosis) Pathway with SPEED. Comparison was made to; MRI usage, referral to MRI, and yield of clinically significant PC.
All SPEED patients were invited to complete a patient experience survey and thematic analysis was conducted.

Results 
(See table)
Analysis of patient experiences identified key themes that enhanced patient experience; robust clinical review, pathway coordination and supportive care.

Conclusion 
MRI pre-biopsy is poor corporate governance of a valuable resource. Effective clinical triage of patients makes most efficient use of MRI and enables assessment and management of presenting symptoms to run in parallel with a PC diagnosis. Patients appear highly satisfied with this approach.
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