Development of pre-admission information for referrals with suspected interstitial lung disease to a specialist unit

Background: Differentiating disorders of the interstitium is complex. Patients are referred to specialist centres to establish a diagnosis; a process associated with anxiety. We hypothesised that lack of information prior to the hospital stay was a cause of anxiety. Aim: To characterise patients9 information needs prior to admission for diagnostic work-up; to identify causes of anxiety in patients prior to / during admission; to identify gaps in patient9s expectation and service delivery. Methods: Qualitative: audio recorded semi structured interviews. Patients (n=8); clinical staff (n=5) purposively selected in a specialist ILD unit. Transcripts underwent thematic and content analysis. Severity of the ILD was classified according to CPI and 6MWT. Patients completed Hospital Anxiety u0026 Depression scale and EQ-5D-5L at entry. Results: Patients9 main source of anxiety was uncertainty of diagnosis. Patients reported that the volume of pre-admission information was adequate but the content needed to be clearer and include practical information. 50% (n=4) recorded HADs ≥ 7 for anxiety and / or depression. 25% (n=2) recorded moderate – severe difficulty on EQ-5D-5L. Junior staff reported a lack of appropriate knowledge to discuss differential diagnosis effectively. Conclusion: This small study demonstrates the need to involve patients in developing pre admission information so that it is relevant to their needs. This is an iterative and collaborative process led by the clinical nurse specialist. In house training to up skill junior staff on their knowledge of ILD9s has been implemented. The impact of improved information and training is being evaluated.