Download Plan - Central Cancer Network

Regional MDM Development
Project Plan
Project
Name
Regional MDM Development
Document
Name
Project Plan
Document
Identifier
Project Plan
Authorities
Regional MDM Development Project Plan
Version:
01_02 Draft
Date:
17 October 2012
Author:
Phyllis Meier
Page 1 of 10
Regional MDM Development
1
Project Plan
Background
In February 2006 the Ministry of Health (MOH) allocated funds to the DHBs
to develop a number of initiatives including supporting Multidisciplinary
teams. Each DHB identified the establishment of Multidisciplinary teams in
their cancer control plans, but it was found there was variable progress
across the DHBs on the actions.
Regional Cancer Networks were established in 2007 and were committed to
improving the journey for cancer patients, their careers, and whanau.
Central Cancer Network (CCN) in collaboration with all the regional
networks developed a regional network framework, and from that work a
Multidisciplinary Meetings (MDM) Framework was developed. The CCN MDM
Framework was developed to consider and guide the formation of each
DHBs own MDM framework.
Activity across the CCN region to date includes:

The implementation of a regional conferencing solution

A formal process for MDM coordination adopted by the two cancer
centres and two regional DHBs

The development and testing of electronic MDM proformas for data
capture and pathway monitoring at CCDHB, with plans for adaptation
at HVDHB.
In 2012/13 multidisciplinary meetings (MDMs) have been identified as a
government priority and the MOH developed a “Guidance for implementing
quality Multidisciplinary meetings” document. CCN in collaboration with the
Ministry of Health have been working to support the improvement and
standardisation of cancer related MDMs through out the region.
The CCN Regional Development Project will continue to support DHBs to
develop specialist cancer MDMs over the next 12 months for all main cancer
tumour types and will continue to support cancer tumour types as needed
that do not fall under the Faster Cancer Treatment Tumour Streams work.
2
Plan Description
The plan will enable the region to implement the national Guidance for
Implementing Quality MDMs, and includes:

Transition to a video-conferenced environment for specialist cancer
MDMs as enabled by the CCN conferencing project

Formalising referral pathways and TOR for MDMs

Transition to regional electronic MDM proforma to allow:

data collection as enabled by CRISP

collection and reporting MDM attendance data to provide baseline
access statistics

Implement appropriate coordination roles to support the effective
functioning of MDMs

Develop a regional funding model to ensure funding is channelled
appropriately between DHBs that host MDMs and referring DHBs
Regional MDM Development Project Plan
Page 2 of 10
Regional MDM Development
3
Project Plan
Plan Prerequisites
Plan prerequisites that must be in place and/or remain in place for the plan
to succeed include, but are not limited to, regional videoconferencing
solution (completion date December 2012), CRISP program of work
(completed prior to full implementation of Concerto SMT documentation in
the region), and ongoing or developing regional tumour stream pathways.
4
External Dependencies
The MDM Development Project Plan is an implementation plan that aligns
with and may be influenced by, the MOH’s Faster Cancer Treatment (FCT)
initiatives, as well as the clinical and business service needs of the region.
Specifically this includes:
1. Faster Cancer Treatment Regional Implementation Plan
The FCT Regional Implementation Plan is a key priority initiative of
the faster cancer treatment project and forms part of Stage 1 of the
wider Faster Cancer Treatment programme. The plan is the basis on
which DHBs will be accountable for delivery of the Faster Cancer
Treatment indicators to the Ministry of Health.
2. National Tumour Stream Standards
Standards relating to MDM discussion criteria and minimum data set
due June 2013
3. Regional DHB Service Plan (RSP)
Relevant activities include:

Improve the functionality and coverage of multidisciplinary
meetings by June 2013
4. Regional Information System Plan (CRISP)
CRISP moves the DHBs to a suite of shared, standardised and fully
integrated information systems that will enhance clinical practice,
drive administrative efficiencies, enable regionalisation of services
and reduce current operational risk. Phase 1 includes deliverables
such as a regional Picture Archiving and
Communication System (PACS), a regional clinical workstation and
clinical data repository, and the replacement of legacy patient
administration systems (reference: Central RSP 2012/13).
5
Assumptions
CCN will provide project management resource when, and as required, for
this work as part of the commitment to the Faster Cancer Treatment
programme.
DHBs are committed to and have included MDM development in their
annual plans and will collaborate with CCN on the activities identified below.
6
Monitoring and Control
An Advisory Group will be established to guide the project. The Regional
FCT Steering Group will provide the project executive role and monitor FCT
Regional MDM Development Project Plan
Page 3 of 10
Regional MDM Development
Project Plan
programme development for the region. They will monitor the progress of
the MDM Regional Development Project via Highlight Reports, and briefings
from the Project Manager.
7
Funding
$2m sustainable annual funding nationally (approx $455k pa for the CCN
region (PBF split)) has been identified to extend MDMs for all main cancer
tumour streams. The table below identifies funding for MDM development
across all DHBs within the region.
DHB
CCDHB
HBDHB
HVDHB
MDHB
TDHB
Wairarapa DHB
Whanganui DHB
TOTAL
MDM Funding PBF split for 2012/13
117,490
78,556
63,909
82,892
54,829
21,757
35,335
454,768
DHBs have committed a proportion of this funding ($150,809) for the
provision of a regional video conferencing solution. The remaining portion
($303,959) will be used to fund additional MDM activity outlined below.
Areas that may require some investment have been identified and will
require final approval from Regional Coo’s and GM’s.
Work that is required to be undertaken over the next 12 months and may
require funding includes:
ACTIVITY
FUNDING
REQUIRED
The regional videoconferencing (VC) solution is implemented
across all sites by December 2012
Clinicians establish which MDMs are suitable for VC and agree
to which MDM will require additional Clinical support.

Develop a regional funding model to ensure
funding is channelled appropriately between host and
referring DHBs
MDM referral pathways are agreed and processes established
for all local and regional MDMs
Yes – identified
above
This may require
additional
investment
MDM coordination/administration:
 The function of MDM coordination is scoped at each
site
MDM audits and reporting requirements to be developed and
maintained around MDM processes, clinical audits, and access
to MDMs.
Written information is provided prior to the presentation of a
patient’s case at an MDM
Regional MDM Development Project Plan
If service changes
are required there
may be financial
implications
Individual DHBs
may identify
additional costs in
business cases
This may require
additional
investment
This may require
additional
investment and or
IT solutions
Page 4 of 10
Regional MDM Development
8
Project Plan
Schedule
The project is expected to require 12 months to complete, but may
complete in the range 10-16 months. The aim of this project is to align the
regional MDM development project with the MOH guidance for implementing
quality multidisciplinary meetings.
High level overview of project to include:

Regional VC Solution

Leadership

Coordination and access

Documentation

Audits
The key dates of the project are shown in the following table.
Key: AC= Actions to Commence, U= Actions Underway, C= Actions Complete
Item
Deliverables
1
Implement a regional VC solution
Milestone
Lead
Responsibility
Estimated
Completion
Date
Status
∆
ConnectNZ,
Gen-I, CCN
Dec 2012
U
ConnectNZ,
Gen-I, CCN
Jul 2012
C
ConnectNZ,
Gen-I, CCN
ConnectNZ,
Gen-I, CCN
ConnectNZ,
Gen-I, CCN
ConnectNZ,
Gen-I, CCN
Clinical Lead,
Cancer
Manager, MDM
Coord
Clinical Lead,
Cancer
Manager, MDM
Coord
Clinical Lead,
Cancer
Manager, MDM
Coord
Cancer
Managers
Cancer
Managers,
MDM Coord
Cancer
Manager, MDM
Coord
Jul 2012
C
Aug 2012
C
Nov 2012
U
Dec 2012
AC
May 2013
AC
May 2013
AC
Jun 2013
AC
Oct 2012
U
Feb 2013
AC
Mar 2013
AC
DHBs sign Gen-I contract
2
3
Product procurement
4
System preparation (proof of
concept)
Site installation (including training at
each site)
Final signoff/handover from
ConnectNZ
5
6
7
Develop ToR
8
Case Presentation Criteria to be
included in ToR (Confirm against
National Standards)
9
Agree to ToR
10
Establish single point of Coordination
for MDMs based on DHB needs
11
Develop and document MDM role(s)
based on DHB needs
12
Agree to MDM role document
Regional MDM Development Project Plan
∆
∆
∆
Page 5 of 10
Regional MDM Development
Item
13
14
15
16
17
18
19
20
21
22
Deliverables
Regional MDM schedule developed
and confirmed by DHBs (Current
State)
MDM Chairs identified for each MDM
(ToR)
MDMs identified as VC suitable or
non-suitable
Identify and agree to MDMs requiring
additional support (Membership, ToR)
Obtain additional support for MDMs
identified as requiring additional
support (Membership, ToR)
Revise Regional MDM Schedule and
circulate
Referral pathways established and
agreed (Who, How, When)
Develop Criteria for patients to be
discussed in MDM (by Tumour
Stream, inclusion or exclusions)
Tumour type specific core data is
identified (revised by National
Tumour Stream Work as needed)
Tumour type specific core data is
agreed (National tumour stream work
or other tumour specific work group)
23
Refine Concerto SMT documentation
(Consider CRISP program)
24
Agree to Concerto SMT content (by
Tumour Stream)
Develop Non-Concerto
Documentation (Consider Concerto
SMT)
Agree to Non-Concerto content (by
Tumour Stream)
Develop and agree to method for
recording of attendance (ToR)
Interim tumour type specific core
data collection method developed
(Concerto SMT and Non-Concerto)
Protocol for timely communications
built into documentation (GP, Clinical
Teams, Other referrers)
25
26
27
28
29
30
31
32
Project Plan
Lead
Responsibility
Estimated
Completion
Date
Status
MDM Coord,
CCN
Nov 2012
U
Clinical Lead,
MDM Coord
Clinical Lead,
MDM Coord
Clinical Lead,
MDM Coord
Nov 2012
U
Nov 2012
AC
Dec 2012
AC
∆
Clinical Lead
Dec 2012
AC
∆
CCN
Jan 2013
AC
∆
Clinical Lead,
MDM Coord
Feb 2013
AC
Clinical Lead
Feb 2013
AC
Clinical Lead
Mar 2013
AC
∆
Clinical Lead
Apr 2013
AC
Mar 2013
AC
∆
Clinical Lead,
MDM Coord,
CCN
Clinical Lead,
MDM Coord
Apr 2013
AC
Clinical Lead,
MDM Coord
Mar 2013
AC
Clinical Lead,
MDM Coord
Apr 2013
AC
MDM Coord
Apr 2013
AC
Clinical Lead,
MDM Coord
Mar 2013
AC
MDM Coord
Mar 2013
AC
Clinical Lead,
Cancer
Manager, MDM
Coord
Apr 2013
AC
MDM Coord
Mar 2013
AC
MDM Coord
May 2013
AC
MDM Coord
Jun 2013
AC
MDM Coord
Jul 2013
AC
Milestone
∆
∆
Agree to Documentation processes
Develop Audit tool for MDM processes
based on "MOH Guidance of
Implementation of Quality MDM"
DHBs agree on an audit tool for
monitoring MDMs
33
Implement Audit tool
34
MDMs are audited using the audit tool
Regional MDM Development Project Plan
∆
Page 6 of 10
Regional MDM Development
Item
Deliverables
Project Plan
Milestone
to report to FCT Steering Group
Develop Audit tool for tumour specific
core data collection
DHBs agree on an audit tool for
monitoring tumour specific data
35
36
∆
Lead
Responsibility
Estimated
Completion
Date
Status
Clinical Lead,
MDM Coord
Clinical Lead,
MDM Coord
Clinical Lead,
MDM Coord
Mar 2013
AC
May 2013
AC
Jun 2013
AC
Clinical Lead,
MDM Coord
Jul 2013
AC
Mar 2013
AC
May 2013
AC
Jun 2013
AC
Jul 2013
AC
37
Implement Audit tool
38
MDMs are audited using the audit tool
to report to MDM groups or tumour
stream work groups
39
Develop Audit tool to demonstrate
access to MDMs
40
DHBs agree on an audit tool for
monitoring access to MDMs
41
Implement Audit tool
42
MDMs are audited using the audit tool
to report to Measures for National
Health Board (PP24)
Clinic Lead,
MDM Coord,
CCN
Clinic Lead,
MDM Coord,
CCN
Clinic Lead,
MDM Coord,
CCN
Clinic Lead,
MDM Coord,
CCN
43
Regional funding needs identified
CCN
Apr 2013
AC
44
Regional Funding model is developed
CCN
May 2013
AC
45
DHBs agree to proposed funding
model
Regional funding model is
implemented
Identify best method for Patient
Information distribution (Care
Coordination work)
MOH Guidance for implementing
quality MDMs implemented for
Central Cancer Network Region
CCN
Jun 2013
AC
CCN
Jul 2013
AC
∆
Care Coord,
CCN
Mar 2013
AC
∆
DHBs
Jul 2013
AC
46
47
48
∆
Key: AC= Actions to Commence, U= Actions Underway, C= Actions Complete
9
Key Performance Indicators (KPI)


Regional MDM Development Project milestones
Access to MDMs
o Percent of patients discussed at Specialist MDMs annually in
comparison to number of new cancer registrations for year (target to
be determined by regional tumour standards)
Regional MDM Development Project Plan
Page 7 of 10
Regional MDM Development
10
Project Plan
Risks and Opportunities
This Risk Register Summary provides a record of identified risks relating to this project, including their description, probability,
impact, proximity, responses, and owner. It is used to capture and maintain information on all of the identified threats and
opportunities relating to this project.
The Risk Register Summary should be monitored by the Project Manager on a regular basis.
ID
Description
Probability
Impact
Proximity
Responses
Owner
R001
Cause: ConnectNZ unable to supply equipment
for Videoconferencing (VC) solutions.
Event: VC solution incomplete at estimated
completion date.
Effect: VC solution is not accessible to clinicians
for regional MDMs.
Inherent: L
Residual: L
Inherent: H
Residual: M
Impact
greatest
during VC
DHB
implementati
ons.
ConnectNZ
CCN
R002
Cause: Clinicians across the region do not feel
they have the time or resources to engage in the
regional MDM development project plan.
Event: Clinicians across the region do no
engaged or adopt MOH Guidance for
implementing quality multidisciplinary meetings.
Effect: Inability to complete Regional MDM
implementation.
Inherent: H
Residual: M
Inherent: H
Residual: M
Impact great
at with all
aspects of
MDM
implementati
on
Reduce: Maintain
communications with
ConnectNZ project manager
to ensure all equipment and
required staff are present
during installations.
Fallback: Technical issues
regarding VC
implementation to be
escalated to the
ConnectNZ, Gen-I,
Telecom, CCN workgroup.
Reduce: MDM
Implementation Groups to
have clinical membership
and a clinical engagement
strategy
Fallback: Clinical
engagement issues to be
escalated to the FCT
regional steering group
Regional MDM Development Project Plan
Page 8 of 10
DHB Clinical
leads
Regional MDM Development
Project Plan
R003
Cause: DHB Cancer Service Managers across the
region do not feel they have the time or
resources to engage in the regional MDM
development project plan.
Event: DHB Cancer Service Managers across
the region do no engaged or adopt MOH Guidance
for implementing quality multidisciplinary
meetings.
Effect: Inability to complete Regional MDM
implementation.
Inherent: H
Residual: M
Inherent: H
Residual: M
Impact great
at with all
aspects of
MDM
implementati
on
Reduce: MDM
Implementation Groups to
have clinical membership
and a clinical engagement
strategy
Fallback: Clinical
engagement issues to be
escalated to the FCT
regional steering group
DHB Cancer
Service
Managers
R004
Cause: MOH has set caps for non clinical rolls in
each of the DHBs.
Event: FTE caps in DHBs impact on the ability to
implement MDM Coordinator roles.
Effect: Inability implement Regional MDM
development plan as a result of lack of resources.
Inherent: H
Residual: H
Inherent: M
Residual: M
Impact at all
stages of this
project
Transfer: MOH to
investigate how this could
be addressed
MOH
Cause: Funding and project focuses shift during
the life of the project as a result of
interdependent projects outside of the scope of
this project.
Event: The interdependencies of other projects
e.g diagnostic indicators, CRISP, may affect the
outcome of this project
Effect: Inability to follow through with the
original intent of this project.
Inherent: H
Residual: M
R005
Regional MDM Development Project Plan
DHBs
CCN
Inherent: H
Residual: M
Impact great
at all three
stages of
project
Page 9 of 10
Accept: Monitor ongoing
projects and the
interdependencies as this
project proceeds
Fallback: Changes to
interdependent projects
that may affect this project
to be escalated to the
regional steering group.
Transfer: Continue
engagement with MOH
CCN
FCT
Steering
Group
MOH
Regional MDM Development
Project Plan
Document History
This document is only valid on the day it was printed.
The source of the document will be found in the
I:\FUNDING\Common\Cancer\Central Cancer Network\Phyllis Work
in Progress\CCN\MDM Aug 2012\Project Documents\Project Plan
directory.
Document
Location
Revision
History
Version
Number
01_00
01_01
01_02
Revision
date
03Jul2012
10Oct2012
17Oct2012
Approvals
Name
Distribution
Summary of Changes
Original
Updated original project plan
Plan overview included
This document requires the following approvals.
Signed approval forms are filed in the
I:\FUNDING\Common\Cancer\Central Cancer Network\Phyllis Work
in Progress\CCN\MDM Aug 2012\Project Documents\Project Plan
directory.
Signature
Title
Date of
Issue
01Jul2010
Version
01_00
This document has been distributed to:
Name
Jo Anson
Regional FCT Steering
Group
Regional GMs / COOs
Title
CCN Program Director
Regional MDM Development Project Plan
Page 10 of 10
Date of
Issue
01Jul2012
16Oct
2012
17Oct
2012
Version
01_00
01_01
01_02