Poster Presentation Cancer Survivorship 2017

Developing a sustainable model of care for cancer survivors (#56)

Genevieve Johnston 1 , Wanda S Stelmach 1 , Hugh Burch 1 2 , Claire Consiglio 1 , Cheryl Murray 1
  1. Northern Health, Epping, VIC, Australia
  2. NEMICS, Heidelberg, VIC, Australia

Background: Due to improvement in treatment options, the number of cancer survivors is increasing. All survivors should receive a Survivorship Care Plan (SCP) to guide holistic care of chronic treatment morbidities, meet information needs and assist transition to primary healthcare. In Australia, SCPs are not routinely implemented with barriers including: limited advocacy from clinical leaders, limited coordination between acute and primary healthcare practitioners, and a lack of resources.

Aim: To investigate the sustainable implantation of SCPs across Victorian health services and to determine the potential decrease in reliance on outpatient appointments for the breast team at Northern Health (NH).

Method: This research had two phases. Benchmarking was undertaken through consultation with with five Victorian co-ordinators that have introduced survivorship models of care. Modelling was then undertaken to determine the number of NH breast cancer patients eligible for GP follow up via a Shared Care model, and the potential decrease in reliance on NH outpatient appointments.

Results: Benchmarking indicated that the completion of SCPs with patients is resource intensive. This is a significant barrier to sustainable implementation. Subsequently, survivorship models have been implemented in tumour streams with embedded dedicated nurse co-ordinators. The mean annual number of people diagnosed with breast cancer at Northern Health between 2010-2015 was 79.2 (±9.85). Of these, 62% met the criteria for Shared Care and the mean annual number of people eligible was 48.67(±5.51). If eligible patients were to have every second appointment with their GP, whilst still maintaining Cancer Australia’s recommendations for review, a shared care model could save 1715 acute outpatient appointments over a 5 year period.

Conclusions: Shared Care can decrease reliance on acute outpatient appointments, improve patient flow and potentially decrease waiting time for newly diagnosed breast patients. Health services require dedicated staffing to ensure care plans are sustainably implemented across tumour streams.

  1. Institute of Medicine and National Research Council of the National Academies, From Cancer Patient to Cancer Survivor: Lost in Transition. 2006, Washington, D.C.: The National Academies Press.
  2. Mayer, D., et al., American Society of Clinical Oncology clinical expert statement on cancer survivorship care planning. Journal of Oncology Practice, 2014.
  3. Birken, S., et al., Determinants of Survivorship Care Plan Use in US Cancer Programs. Journal of Cancer Education, 2014. 29(4): p. 720-7.
  4. Grunfield, E., et al., Randomized Trial of Long-Term Follow-Up for Early-Stage Breast Cancer: A Comparison of Family Physician Versus Specialist Care. Journal of CLinical Oncology, 2006. 24: p. 848-55.
  5. Cancer Australia. Shared follow-up care. 2013 9.2.15 [cited 2016]; Available from: https://canceraustralia.gov.au/publications-and-resources/cancer-australia-publications/shared-care-information-women.