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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