Establishing a multidisciplinary one-stop thyroid clinic: an innovative model to expedite thyroid cancer diagnosis and enhance patient-centered care

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BACKGROUND: The rising incidence of thyroid nodules has led to increased referrals under the 2-week wait pathway, despite a low malignancy rate. This places pressure on healthcare systems. We developed a multidisciplinary one-stop thyroid clinic (OSTC) to streamline diagnostics and improve patient experience. METHODS: The OSTC was established in three phases: incorporating real-time ultrasound-guided fine needle aspiration (FNA), rapid on-site evaluation (ROSE) of cytology, and same-day multidisciplinary team (MDT) decision-making. Patients referred with thyroid nodules underwent clinical, biochemical, radiological, and cytological assessment, with results and management plans delivered on the same day. Data on demographics, investigations, cytology, surgery, histology, and follow-up were collected prospectively from January 2022 to October 2023. The RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, Maintenance) was used to evaluate implementation. RESULTS: A total of 508 patients were assessed; 81% were female with a median age of 51 years. FNA was performed in 46% of cases. ROSE reduced non-diagnostic (Thy1) cytology from 16% to 5%. About 62% of patients received a definitive management plan on the same day; 29% were referred for surgery, and 10% were diagnosed with thyroid cancer. The non-attendance rate in OSTC was significantly lower (1. 6%) than standard clinics (12. 4%; P < 0. 0001). Same-day MDT review facilitated prompt decisions and reduced diagnostic delays. RE-AIM evaluation confirmed wide reach, improved diagnostic yield, team-wide adoption, efficiency, and sustainability. CONCLUSION: The OSTC model delivers faster, more accurate thyroid nodule assessment with reduced appointment burden and improved diagnostic yield. It is a reproducible and cost-effective model that supports NHS priorities and enhances patient-centered care.

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