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Planned Care Innovation Exemplars

Radiology Pathway Navigation – A New Direction

Louisa Edwards-Brown, Project Lead, CT Advanced Practitioner
Sarah Maund, Radiology Cancer Navigator
Sharon Donovan, Radiology Department Manager

Cwm Taf Morgannwg University Health Board

All Radiology patients need to attend in person for each examination they require, however this can cause limitations to patient flow in terms of urgent and planned care. All Radiology modalities collaborate well however, there is no continuous path or connection for each patient or between each modality. Delays can develop from this loss of connection lengthening the patient pathway. Streamlining this system would allow a more synchronous patient journey leading to more prompt diagnosis and optimal treatment options.

Radiology investigations and procedures, along with the pathway process can cause unnecessary anxiety for patients. Introducing new Radiology pathway systems will provide more clinical coordination for the patient ensuring they receive a seamless experience. Work is also required on pre appointment patient information and developing an electronic referrals system, both of which can contribute significantly to throughput, flow, and patient experience. This improved pathway system of coordination will significantly support the delivery of the Single Cancer Pathway (SCP).

The aim of the project is to implement a new Radiology Navigation system by attaining these key objectives:

  • Streamline and reduce delays in radiology pathways.
  • Reduce the waiting times from request to appointment.
  • Provide coordinated care for those patients requiring multiple examinations.
  • Provide a Radiology point of contact for patients and pathway teams.
  • Improve pre and post procedure patient information – developing online access.
  • Improve the Radiology referral system.

Work will involve reviewing each National Optimal Pathway within cancer services, beginning with Lower GI and Lung pathways. Process review will be undertaken for Radiology requesting which will include following each specialty request into each modality using process mapping. This data will show throughput time frames with any suspect areas of concern being targeted for development, by streamlining and changing the processes used. Using these newly developed streamlined pathways will reduce footfall within the department, lowering the resources needed and preventing patients from not attending. A Radiology Navigator will provide a link between each Pathway within cancer services, connecting the patient to Radiology and providing more beneficial Radiology information. Patients will be able to have more telephone contact and conversations, with more appropriate opportunity for discussion of procedures in greater detail if necessary, with written information available.

The Outcomes/ Benefits

  • Vetting process reduced from 5 to 2 days.
  • 7 touch points reduced to 4.
  • Average wait from colonoscopy to CT staging referral reduced from 13 to 4 days (target – 10).
  • 996 hours of radiology and management time released by the dedicated role.
  • CT scanning capacity increased to 118%, with 530 extra patients scanned during the project period.
  • Improved patient experience.


What next?

  • Ongoing collaboration with cancer colleagues and network to promote the role.
  • Funding sought to expand the offering through CTMUHB, to include a ‘Navigator Assistant’.

View project posters and slides from the PCIP National Showcase Event