Category: Innovative Dissemination Rehabilitation for Operated lung Cancer (ROC) programme Amy Kerr (nee Bradley), Mr R. Steyn, Mr P.B. Rajesh, Mr M. Kalkat, Mr E. Bishay, Prof B. Naidu Department of Thoracic Surgery, Heart of England NHS Foundation Trust, Birmingham, United Kingdom Category: Innovative Dissemination INTRODUCTION 5000 patients in the UK undergo curative lung cancer surgery for cancer. 15% of patients develop complications that are associated with an increased risk of death, intensive care admission, and hospital length of stay. SPREADING THE PROGRAMME Birmingham Heartlands hospital is the regional thoracic centre and takes referrals from 12 hospitals. A number of strategies were implemented to spread the programme outside the Trust, including: Document key steps required to set up the programme Identify local stakeholders for each referring hospital Use evidence of benefits gathered during testing to open up a dialogue with local stakeholders Support setting up local rehabilitation programmes with training, documentation and visits to the Thoracic ward at Heartlands Refine local pathways On-going measurement of improvements Development and distribution of ROC DVD for national spread SCAN HERE TO SEE PATIENT VIDEO FEEBACK ABOUT THE ROC PROGRAMME QR CODE METHODS The Rehabilitation for Operated Lung Cancer (ROC) programme is a multi-faceted programme, designed to optimise fitness for lung surgery, reduce incidence of complications, and support the Enhanced Recovery After Surgery (ERAS) pathway. The ROC programme includes four components: pulmonary rehabilitation, smoking cessation support, dietary advice and patient education. Components are widely available, but rarely utilised in this patient group. Press coverage of the programme has facilitated wider dissemination TRY OUT THE NEW ROC ‘APP’ ONGOING IMPROVEMENT Initial results were disseminated locally and at key national meetings to enable ROC programme adoption in other hospitals throughout the UK. Patient and health care professional feedback of the 1000 DVDs distributed nationally has been excellent. The DVD has won several national prizes. For ipad DVD FEEDBACK FROM PATIENTS “Excellent, very informative and able to prepare for surgery better” Was it useful? “Yes, definitely, it told me what I needed to know and also do the exercises, cause I only went to one class before surgery” “It was all useful, could not be improved.” “I think my breathing has improved since doing the exercises.” OUTCOMES Implementation of the programme reduced the incidence of post-operative pulmonary complications by 7% (16% to 9%). Hospital readmissions due to surgical complications fell by 9% (14% to 5%) There was also a reduction in ITU admissions and measurable cost savings. ROC: PUBLISHED DISSEMINATION NHS Improvement. ‘Fulfilling the Potential: A Better Journey for Patients and a Better Deal for the NHS (Enhanced Recovery)’ http://www.improvement.nhs.uk/documents/er_better_journey.pdf Cancer Rehabilitation. ‘Making excellent cancer care possible’ National cancer action team - national cancer programme (March 2013) Pulmonary rehabilitation programme for patients undergoing curative lung cancer surgery. Eur J Cardiothorac Surg. 2013;44(4):e266- 71. DVD FEEDBACK FROM CARERS “Although it made me cry, I was really glad I watched it. I feel I can understand what my Mum will go through.” “I watched on behalf of my mother. The information given helped me a lot to understand what she was facing and how it was going to be done.” CONCLUSIONS Patient optimisation prior to surgery improves outcomes. Patient education and information are cornerstones of good surgical practice. Centres across the UK have adopted the ROC programme, and are using the DVD to facilitate this. Roc now has recognised as a example of good practice in national enhanced recovery guidelines An ‘APP’ is now been developed to facilitate wider dissemination. DVD FEEDBACK FROM ALLIED HEALTH PROFESSIONALS “I think it gives them a better resource than verbal or written info and the use of real people to watch is more appropriate. Preparation at home in this way is more helpful” CONTACT DETAILS:: amy.kerr@heartofengland.nhs.uk