Graduation Semester and Year
Fall 2026
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Dr. Kim Siniscalchi
Abstract
National Comprehensive Cancer Network guidelines recommend biomarker testing for patients with advanced-stage non-small cell lung cancer. Delays in ordering biomarker testing increase turnaround time (TAT) and delay initiation of targeted therapy. National benchmarks recommend biomarker result TATs of 10-14 days. Evidence suggests reflex biomarker testing at time of pathologic diagnosis reduces TAT and improves workflow efficiency. This quality improvement (QI) initiative implemented reflex biomarker testing for patients newly diagnosed with advanced-stage lung cancer to reduce biomarker testing TAT by 7–14 days within an interventional pulmonary service line. The QI used a pre-post design guided by the Plan-Do-Study-Act (PDSA) framework and was conducted over 8 weeks at an academic medical center in North Texas. Interventional Pulmonary providers placed biomarker testing orders at the time of pathologic diagnosis or at a post-procedure visit. Electronic medical record data were collected to compare pre- and post-intervention TATs. Provider attitudes, knowledge, and confidence regarding national guidelines and benchmarks, and workflow were assessed using pre-and post-intervention Likert-scale surveys with open-ended questions. Pre-intervention (n=8) data demonstrated a mean TAT of 32 days, and post-intervention (n=15) data showed a mean TAT of 23.93 days, representing a statistically significant reduction of 8.07 days (p=0.045). Provider familiarity, knowledge, and confidence with guidelines and workflow improved following intervention. Reflex testing was a feasible and sustainable workflow intervention that significantly reduced biomarker testing TAT. Future PDSA cycles should address identified barriers, limitations, and consider EMR prompts and expansion to in-house processing.
Keywords
Reflex biomarker testing, Non-Small Cell Lung Cancer, Biomarkers, Turnaround time, Quality improvement
Disciplines
Nursing | Quality Improvement
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Hooper, Tonya, "Interventional Pulmonary Reflex Biomarker Testing in Advanced-Stage Lung Cancer" (2026). Doctor of Nursing Practice (DNP) Scholarly Projects. 29.
https://mavmatrix.uta.edu/nursing_dnpprojects2/29