About the toolkit
Lung nodules found by chance are one of the most underused routes to earlier lung cancer diagnosis. Incidental pulmonary nodules (IPNs) show up on imaging carried out for reasons unrelated to lung cancer. Most are benign, but for those that are not, a structured IPN management programme can make the difference between an early and a late diagnosis.
This toolkit helps people and teams to plan, design and deliver IPN management programmes. Built around a health system readiness approach, it guides you through assessing where your health system stands and what it needs to put a programme in place, whether alongside LDCT screening or where screening is not yet feasible.
New to IPNs? Read our IPN FAQs for answers to common questions about IPNs and why managing them matters.
A framework to support the implementation of IPN management programmes
The framework is the heart of the toolkit. It is organised into six domains, each made up of a series of questions. Answering them will help you identify where your health system is ready, where there are gaps and what the next steps are towards implementation. Supporting resources and interactive tools are provided throughout.
The framework was developed based on a literature review, interviews with subject-matter experts and insights from Network members. It was refined by being tested in five health systems where an IPN management programme is already in place.
The six domains
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Domain 1. Governance and guidelines
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Domain 2. Workforce and technical capacity
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Domain 3. Financial planning
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Domain 4. Engagement, education and equity
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Domain 5. Service delivery
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Domain 6. Data monitoring, evaluation and quality assurance
Domain 1. Governance and guidelines
Domain 1. Governance and guidelines
Domain 1 is the starting point for users working through the IPN management framework. It helps you assess the existing governance conditions in your health system and set the programme up for success from the outset.
Domain 2. Workforce and technical capacity
Domain 2. Workforce and technical capacity
Domain 2 helps you to assess the workforce and technical capacity in your health system and identify what additional resources are needed to implement your IPN management programme effectively.
Domain 3. Financial planning
Domain 3. Financial planning
Domain 3 helps you assess the financial requirements of their IPN management programme, covering budget and impact, cost-effectiveness, return on investment and the financial implications for service users.
Domain 4. Engagement, education and equity
Domain 4. Engagement, education and equity
Domain 4 helps you identify routes to engage key staff, build awareness and improve education around IPN management, and support service users throughout the IPN management care pathway.
Domain 5. Service delivery
Domain 5. Service delivery
Domain 5 helps you identify the processes needed to ‘find, track and manage’ nodules through the programme, and to consider how it integrates with existing health system services.
Domain 6. Data monitoring, evaluation and quality assurance
Domain 6. Data monitoring, evaluation and quality assurance
Domain 6 helps you identify and leverage the data processes already in use in their health system, and to develop approaches to measure, assess and improve programme performance.
Learn from real IPN management programmes
Five case studies demonstrate how programmes have been planned, implemented and improved in different health systems, from AI-enabled workflows in Brazil to a nodule service led by advanced practitioner radiographers in Nottingham. Each case study includes the background that led to the programme being established, its ‘find, track, manage’ workflow and key takeaways. Use these to inform the design and planning of your own programme.
Resources to help you apply the toolkit
Guidance, background and further reading to support you as you work through the framework.
Your guide to using the toolkit
A summary of everything in the toolkit and how each resource aligns with the framework’s domains. Start here if you want to know what is available and where to find it.
How the framework was developed
Find out how the framework was built, including the literature review, semi-structured expert interviews and review by experts and Network members, and why you can rely on it.
Expert perspectives
Hear from Professor David Baldwin, Dr Luis Raez and Dr Renelle Myers on key considerations for specific domains of the framework, and how they apply when setting up an IPN management programme.
Dr Renelle Myers, Interventional Pulmonologist, Vancouver General Hospital
Glossary
New to a term or acronym? Find clear definitions of the key terms used across the toolkit.