Aim To develop a standardised state-wide workflow for the diagnostic assessment and management of suspected lung cancer following National Lung Cancer Screening Program (NLCSP) implementation.
Methods International and Australian literature and care models were reviewed, alongside a Cancer Institute NSW Lung Cancer Screening Implementation and Monitoring (LCSIM) Group survey assessing practice, infrastructure, resourcing, and best practice. Core clinical events and task checklists allocated responsibilities across multidisciplinary roles, incorporating nurse-led assessment. State-wide referral criteria, NLCSP guidance, TSANZ Nodule Management Guide, and Optimal Care Pathway indicators were integrated.
Results A state-wide pictorial workflow and task framework standardise workup across screening and non-screening pathways. It incorporates structured triage, validated risk assessment, synoptic nodule documentation, and audit systems. Nurse-led assessment, smoking cessation, and early supportive care are core elements. A flexible, needs-based workflow allows personalised, timely care over rigid sequential progression. Pulmonary nodule multidisciplinary meetings (MDMs) and escalation pathways for high-risk lesions, surgery, trials, and palliative care are embedded. Inter-departmental responsibilities are mapped for coordinated care.
Conclusions LCSIM created a pragmatic framework standardising state-wide lung cancer diagnostic pathways. Integrating screening pathways, referral criteria, and quality standards reduces variation, delivering scalable, person-centred care. Nurse-led assessments and nodule MDMs serve as core diagnostic components. Implementation enables ongoing pathway performance evaluation.