Download 20 WCMICS Annual Report 2012/13

Annual Report
2012/13
WCMICS would like to acknowledge the Victorian
Department of Health for their funding in 2012/13.
WCMICS would also like to thank the health service staff and consumers who worked with us
throughout the year. The WCMICS team appreciates all of your contributions and looks forward to
working with our colleagues (both in WCMICS and
across Victoria) in 2013/14.
Contents
Foreword
2
About Us
4
Western and Central Melbourne Region
5
WCMICS Statistics
6
Strategic Direction
7
Integrated & Patient Centred Care
10
Supportive Care
12
Information Management & Technology
14
Survivorship & Follow Up
15
Inaugural VICS Conference 2013
16
WCMICS Sharing Event 2012
18
Chemotherapy Community of Practice
20
Consumers
21
WCMICS Funding Program
22
Governance Structure
23
Our Committees & Groups
24
Financial Report
26
Future Directions: 2013/14 & Beyond
27
Our Team
28
Foreword
On behalf of the Western & Central Melbourne
Integrated
Cancer
Service
(WCMICS) we are pleased to present
the 2012/13 Annual Report.
This year we continued to progress the
goals set by the Victorian Cancer Action
Plan 2008-2011 and the WCMICS Strategic Plan 2012/15, building on our previous achievements to ensure Victorians have access to the best possible
cancer care.
the results of their cancer service improvement projects. Further information
about this event and WCMICS presentations is provided on pages 16-17.
Other highlights of 2012/13 included
further work on cancer service planning
activities within the WCMICS region;
supporting clinician participation in Multidisciplinary Meetings through the funding of additional equipment; and the
continued support of member health
services to implement cancer service
A major highlight of the year was
improvements through the significant
WCMICS leadership of the inaugural
investment of the WCMICS Funding
Integrated Cancer Services Conference
Program. In 2012/13 we provided grant
2013, which was a well-attended two-
funding for nine service improvement
day event in Melbourne showcasing the
projects across our member health ser-
significant achievements of the Victorian
vices and saw the completion of eight
Integrated Cancer Services as a whole.
previously funded service improvement
In conjunction with the Department of
projects. As these projects mature,
Health and other ICS, WCMICS helped
WCMICS
facilitate this conference and a number
through its quarterly tumour group
of our clinicians were chosen to present
meetings and annual Sharing Event.
2 WCMICS Annual Report 2012/13 shares
this
knowledge
Communication was a key driver of
everyone involved with WCMICS activi-
2012/13. WCMICS was active in bring-
ties, including clinicians, managers and
ing together statewide leaders in cancer
most importantly our consumers for
care at forums such as the ICS Confer-
their ongoing participation and important
ence, Chemotherapy Redesign Com-
support.
munity of Practice and WCMICS Sharing Event 2012. Along with leading and
participating in these events, WCMICS
We look forward to working with you in
2014.
also continued our active involvement in
joint working initiatives with other Integrated Cancer Services and the Victorian
Comprehensive
Cancer
Centre
(VCCC) project team.
This has been another successful year
for WCMICS and significant progress
was made towards our Strategic Plan
2012/15, which provides a clear strategy for building on our successes in the
years ahead.
A/Prof. Alex Cockram
Chair, WCMICS
Prof. Jeff Szer
Director, WCMICS
We would like to take this opportunity to
acknowledge the work of the Directorate, led by Jenny Byrne, and to thank
WCMICS Annual Report 2012/13
3
About Us
Background Our Cancer Services The Western and Central Melbourne Integrated
Cancer Service (WCMICS) was established in
May 2005. It is one of three metropolitan, five
regional, and one paediatric Integrated Cancer
Service (ICS) established and funded by the Department of Health (DH) to assist with the implementation of the Victorian Government’s cancer
reform agenda.
WCMICS primarily works through its six constituent public hospitals and health services:
Our Objec ves WCMICS main objectives are to:
•
•
•
Meet the needs of people living with cancer
within its geographic area, as well as in other
metropolitan and regional ICS who use
WCMICS services, by facilitating the delivery
of consistent and high quality cancer care;
Enhance integration and coordination of cancer services within its area, including the development of clear and formal communication
processes, referral patterns and relationships
between its primary, secondary and tertiary
services as well as with other ICS services;
and
Develop and manage systems to ensure that
resources are provided, coordinated and managed to fulfil needs and expectations to the
best possible extent.
4 WCMICS Annual Report 2012/13 •
Melbourne Health (MH; Royal Melbourne
Hospital (RMH))
•
Peter MacCallum Cancer Centre (PMCC)
•
Royal Women’s Hospital (RWH)
•
St Vincent’s Health Melbourne (SVHM)
•
Werribee Mercy Hospital (WMH)
•
Western Health (WH)
We are also working towards a broader involvement of other health services within central and
western Melbourne, including:
•
Private hospitals
•
General Practitioner services
•
Community-based health and palliative care
services
•
Community, patient and carer, consumer,
support and self-help groups
These entities provide a comprehensive range of
services covering the full continuum of patient
care, from prevention through screening and early
diagnosis to treatment, rehabilitation and supportive services.
Western and Central Melbourne Region
Our Popula on WCMICS extends from central Melbourne to Werribee, covering the inner municipalities of Melbourne and Yarra, the middle municipalities of
Brimbank, Maribyrnong, Moonee Valley and Hobson’s Bay and the outer north-western municipalities of Melton and Wyndham.
The region’s population is also characterised by
its:
The population of the WCMICS region is one of
the fastest growing in Victoria and makes up
around one quarter of Victoria’s total population.
•
Ageing population structure
•
Relatively high levels of socio-economic disadvantage
•
Multicultural diversity
Source: Department of Sustainability & Environment—29/11/2012
WCMICS Annual Report 2012/13
5
WCMICS StaƟsƟcs
Cancer mortality for residents located in
WCMICS is higher than the rest of metropolitan Melbourne and lower than that for
most regional patients.
WCMICS leading cancer sites; average cases over the last 5 years Avg. mortality rate last 5 yrs
Average Mortality Rate per 100,000 people over the last 5 years, for All Cancers by ICS 105
100
95
90
85
80
Integrated Cancer Service Region
WCMICS has a similar profile when compared to rest of the Victoria.
Individual pa ents treated at WCMICS health services over the last 5 years 18000
16000
Individual patients
Whilst covering the smallest geographic
region of the ICS, WCMICS health services combined treat the highest volume of
cancer patients. The tertiary/quaternary
nature of many of the member hospitals
mean that significant numbers of people
with cancer living in other metropolitan
areas or rural Victoria are also referred to
WCMICS hospitals’ cancer services for
high level and complex diagnosis, treatment and care.
20000
14000
Health Service A
12000
Health Service B
Health Service C
10000
Health Service D
8000
Health Service E
6000
Health Service F
4000
2000
0
2007-08
2008-09
2009-10
Financial year
6 WCMICS Annual Report 2012/13 2010-11
2011-12
Strategic DirecƟon
WCMICS Strategic Direc on WCMICS continues to be guided by the vision for cancer services in Victoria which is articulated in the Victorian Cancer
Action Plan (VCAP) 2008-2011. The VCAP is due for revision and is expected to continue to ensure that the cancer prevention and care Victorians receive is the best that it can be, informed by the latest research and state-of-the-art technologies. WCMICS anticipate the key focus will be ensuring the delivery of the right treatment and support to patients
throughout their cancer journey. The revised VCAP will reflect priorities set within the Victorian Health Priorities Framework 2012-22: Metropolitan Health Plan and the Cancer Services Framework.
WCMICS Consumer Par cipa on Strategy WCMICS embraces consumer participation as a principle integral to its structure, core functions and service improvement initiatives.
The WCMICS Consumer Participation Strategy 2010-12 has been in place since April 2010 and its objectives are:
1.
To ensure all service improvement activities are patient-centred for the delivery of the WCMICS Strategic Plan.
2.
To increase and improve consumer participation in WCMICS.
3.
To collaborate within and across the ICS on consumer participation strategies.
4.
To build the skills and expertise of the individuals involved in patient centred care within WCMICS.
5.
To improve recording, evaluation and measurement of consumer participation in alignment with the WCMICS Strategic
Plan and VCAP.
This strategy was reviewed in 2013.
WCMICS Annual Report 2012/13
7
Strategic DirecƟon
WCMICS Strategic Plan 2012‐15 WCMICS Strategic Plan 2012-15 was developed using a consultative process and will guide the work of WCMICS until
2015. It sets out WCMICS’ overarching goals and the measures required to demonstrate progress against them within a
performance management framework.
In addition to supporting the ICS model, the Strategic Plan is a key enabler to the provision of consistent and integrated
multidisciplinary cancer care across western and central Melbourne.
WCMICS Strategic Plan 2012-15 will be reviewed against the revised VCAP when it is released to ensure consistency
and alignment with state-wide direction for cancer services in Victoria.
Continued progress towards achieving the goals set by VCAP and the WCMICS Strategic Plan was made in 2012/13.
Some of the key projects and activities are highlighted over the following pages. Further information on all WCMICS
activities is available on the WCMICS website - www.wcmics.org
The Victorian Cancer Ac on Plan (VCAP) VCAP outlines the vision for cancer reform in Victoria, with the overall objective of increasing the five year cancer survival rate by a further 10% to 74% by 2015. VCAP identifies four Action Areas:
Action Area 1: Reducing major cancer risk factors in the population and maximising effective screening
(PREVENTION)
Action Area 2: Ensuring rapid translation of research into effective treatments and clinical care (RESEARCH)
Action Area 3: Investing in innovative treatments and technologies and sustainable integrated care systems
(TREATMENT)
Action Area 4: Supporting and empowering patients and their carers throughout their cancer journey (SUPPORT)
The ICS have key responsibility for the delivery of a number of the priorities under Action Areas 3 and 4. VCAP is available from the DH cancer website (www.health.vic.gov.au/cancer/vcap).
8 WCMICS Annual Report 2012/13 WCMICS Annual Report 2012/13
9
Integrated & PaƟent
Centred Care
Integrated & PaƟent Centred Care AcƟviƟes Supporting an improved patient
journey that is fully integrated
between providers is a key goal
of the WCMICS work program.
Key activities under this priority
area in 2012/13 included further
guideline development and implementation, and the continuation of patient treatment pathways in all tumour streams.
WCMICS also continued to support service improvements at the
local hospital level via the ongoing funding for Hospital Administrative Coordinator roles.
Improved pa ent outcomes, pa ent safety and quality assurance by the imple‐
menta on of an Enhanced Recovery A er Surgery Program in gastrointes nal surgical oncology pa ents (led by Dr Georgina Thompson, PMCC) Enhanced Recovery After Surgery (ERAS) programs have been incorporated into routine
perioperative care in many countries and current literature demonstrates it can improve patient outcome, reduce patient length of stay and improve patient safety. Dr Georgina Thompson, anaesthetist from Peter Mac led a project to develop and implement an ERAS program
in the gastro-intestinal surgical oncology patient. This project completed in April 2013, and
some of the key findings from this pilot include:
www.wcmics.org/integrated
•
Reduction in average patient length of stay post-surgery
•
Significant cost savings per patient
•
Improved post-operative clinical care set points (eg. time to 1st post-op oral fluid intake/
solid diet, time to 1st mobilisation)
The continuity of the ERAS program is achieved by the successful business case submission
to Peter Mac, which now funds a new full time role - Perioperative Liaison Nurse from 1st
July 2013. This new role incorporates ERAS and Acute Pain Nursing whilst encompassing
perioperative management.
10 WCMICS Annual Report 2012/13 Development and implementa on planning of clinical prac ce guidelines for the pre‐
ven on of thromboembolism (TE) in pa‐
ents with cancer undergoing major sur‐
gery (led by Dr Kate Burbury, PMCC) One in five gastrointestinal cancer patients may
develop thromboembolism (TE), which is a preventable complication of cancer often accompanied with increased mortality and reduced quality
of life.
Peter Mac haematologist Dr Kate Burbury was
funded to establish and implement clinical practice
guidelines to prevent TE in cancer patients. The
intervention involves the roll-out of patient education and pharmacy packs, which were successfully piloted at Peter Mac and well-received by the
patients. Further implementation at Royal Melbourne Hospital and St Vincent’s Hospital is currently underway, and ultimately, this guideline will
be extended to other tumour streams associated
with higher risk of TE.
The effectiveness of this pilot program will be
evaluated against:
•
Reduction in disease burden,
•
Improvement in patient quality of life
•
Potential cost savings generated
Embedding the WCMICS pathway for colo‐
rectal pa ents at Western Health (led by Jocelyn Collie, WH) A pilot was undertaken between December 2011
and March 2012 at Western Health (WH) to embed the WCMICS Colorectal Patient Pathway into
current and future WH services. The aims of this
pilot were to improve the patient journey and reduce patient risk by improving care coordination.
The project strategies undertaken by the project
team include staff and patient education in addition to promotion of the patient pathway using
flyers and posters at consultation rooms.
Ultimately, the pilot was successful in developing
patient pathways for stage 3 colon cancer and
rectal cancer, as well as patient education sheets
and patient held diary. The use of the hand held
diary was very well received by the patients enrolled in this study.
Western Health looks to further develop this pilot
by considering wider distribution of the diary to all
tumour streams, and possible development into a
smart phone application. The Final Project Report
was submitted at the end of 2012. This two-year pilot program is expected to be
completed by the end of 2013.
WCMICS Annual Report 2012/13
11
SupporƟve Care
SupporƟve Care AcƟviƟes Establishment of a mul disciplinary Pallia ve Care Pathway (led by Dr Adrian Dabscheck, WH) Supportive care is an ‘umbrella’
term for a range of generalist and
specialist services required to
support people with cancer and
their families.
Supportive care incorporates five
domains;
• Physical
• Information
• Social
• Psychological
The primary objective of this project was to develop a holistic palliative care pathway for
patients with cancer who require symptom control and could benefit from community palliative care support. This was achieved through the development of alternative pathways to
planning and delivering appropriate end of life care by facilitating access to medical, pharmacy, allied health and specialist community roles/services. Fundamental to this is the
establishment of a specific outpatient clinic for symptom assessment and management of
oncology patients with advanced disease and issues appropriate for palliative care intervention (the ‘SMART’ clinic).
By improving the integration of care between hospital and community sectors, care can
be provided in a timely and appropriate manner with the provision of consistent symptom
relief, information, psychological/spiritual support, and importantly ensuring people’s
needs are met at the right time, in the place of their choice. Ultimately supporting the
patients and carers in their environments.
The pathway to improve the patient and carer experience achieves:
•
Timely access to early symptom management by specialist palliative care practitioners (hospital and community based services)
•
‘Fast Track’ assessment to avoid acute hospital admission
•
Active management plans tailored to individual patients and their carers, actively
involving consumers in care plans
•
Provision of referral pathways to ongoing care in the community, such as counselling, pastoral care, volunteer support and access to bereavement support: all
of which are provided by community palliative care
•
Care co-ordination across the hospital community setting by providing specialist
nursing roles across hospital and community environments
•
Clinical pharmacist to support care planning and community access to specialised
drugs, particularly emergency medications for the prevention of hospital admission where possible
• Spiritual
Supportive care is a key priority
of the WCMICS work program
and is overseen by the WCMICS
Supportive Care Advisory Group.
In 2012/13 WCMICS funded several more projects aimed at improving supportive care services
in member hospitals.
www.wcmics.org/supporƟve
12 WCMICS Annual Report 2012/13 The SMART clinic commenced in May 2012 and had provided a successful model which
continues and has been expanded from Western Hospital Footscray to the Radiotherapy
Service at Sunshine Hospital. This model of care has been welcomed by health professionals in the hospital and community setting but more importantly has been embraced by
patients and carers.
Early Pallia ve Care for pa ents with Advanced Lung Cancer (led by Dr Brian Le, RMH & Dr Linda Mileshkin, PMCC) In 2012 WCMICS funded the ‘Early integration of
palliative care in oncology (EIPCO) in patients with
incurable lung cancer’ project. The aims of this project
were to implement and evaluate a model of early
palliative care in the management of incurable lung
cancer across three WCMICS hospitals; the Royal
Melbourne Hospital, Peter MacCallum Cancer Centre
and St. Vincent’s Hospital.
Over a twelve month period from August 2012 to August 2013, a palliative care doctor was embedded in
lung outpatient clinics as part of the multidisciplinary
team, seeing patients monthly to address symptom
management, patient and family coping, illness understanding and end of life care planning. Patients were
eligible if they had a diagnosis of incurable lung cancer within the last 90 days and if they received the
majority of their care at that hospital.
Prior to implementation, lung cancer clinicians were
invited to participate in focus groups, interviews and
questionnaires, asking them about their views on this
model of care. In a survey of 42 lung cancer clinicians
almost all (93%) respondents agreed that early referral to Palliative Care is beneficial to patients and 95%
agreed that Palliative Care can benefit patients receiving active treatment. However, only 60% of respondents agreed that all advanced cancer patients should
be referred to Palliative Care. The main reasons for
not referring are if the patient does not have symptoms (60%) and if they can manage the patients’
symptoms themselves (60%).
In total, 104 patients were referred to this model, 23
were later transferred to other services and 3 lost to
follow up. Indicators for quality of care at end of
life will be followed up for the remaining 78 for
comparison to those of incurable lung cancer
patients from 2010, by retrospective audit.
This project will complete in late 2013 and will
assist early palliative care service design.
The management of suppor ve care needs for cancer pa ents (led by Maria Dikeakos, RMH) This project at Royal Melbourne Hospital addressed an area of need for patients in three tumour streams: Head & Neck, Lung and Thyroid.
Previously there was no system in place to identify the supportive care needs of patients and psychology resources were scarce. A system of supportive care screening using the “Distress Thermometer” was introduced.
The screening tool acts as a starting point for
conversations about issues that may not normally
be raised by patients, such as psychological,
financial, transport and relationship problems. For
example the most common concern amongst
head & neck patients was pre-treatment anxiety
and cases such as this could be referred to the
project’s clinical psychologist where appropriate.
Thanks to a shuffling of resources it has been
possible to provide continuing funding for this
psychologist position after the pilot period ended.
The screening process will also continue, with the
nurse coordinator and cancer care coordinator
including screening as part of their normal work
practices.
WCMICS Annual Report 2012/13
13
InformaƟon Management & Technology
This priority area reflects the
need for clinical management
systems and accurate clinical
information to support the delivery of quality cancer care.
Key activities in 2012/13 included
MDM hardware upgrades and
supporting
member
hospitals
with service planning.
InformaƟon Management & Technology AcƟviƟes Mul disciplinary Mee ngs Infrastructure Upgrades WCMICS and CanNet Victoria funded the redevelopment of
the MDM room at RWH to create a state-of-the-art venue for
clinicians to meet and discuss
patient treatment plans. The
upgraded facility now has 3
video projectors and screens, 8
microphones and speakers, and
all the relevant connections to
allow pathology microscope
slides, radiology images and
patient details to be displayed
simultaneously. The meeting
content can also be streamed
online via web conferencing
Schematic of the RWH MDM room
software and a webcam, enabling clinicians from regional areas to log in to the meeting over the internet and discuss
their patients’ treatment plans with the RWH multidisciplinary team.
WCMICS Data Provision (led by Belinda Thomas & Steven White, WCMICS) Working with member health services throughout the project lifecycle, WCMICS has provided the expertise and tools required to enable effective analysis, visualisation and reporting for a wide variety of projects.
In support of the Chemotherapy Day Unit Redesign Project (see page 20), WCMICS designed, developed and continues to support a database, where changes are managed
centrally, and pushed out to sites around the state. Within this framework, information
exchanges remain semantically interoperable, and consistent reporting and analysis is
ensured across all sites.
www.wcmics.org/informaƟon
14 WCMICS Annual Report 2012/13 With hospitals servicing the fastest growing regions in the country, WCMICS continues to
provide comprehensive data analysis to inform decisions and build business cases for
future service provision. Serving as a collaborative resource to its constituent health services, WCMICS has developed a suite of targeted analyses that allow for a clearer understanding of each service’s role in the delivery of cancer care in the state.
Survivorship & Follow Up AcƟviƟes Improving the efficiency and quality of transfer of informa on from specialist to primary care providers in the management of cancer pa ents (led by Mr Cuong Duong, PMCC) This ongoing multi-centred project funded in 2011/12, led by Peter Mac surgeon Mr
Cuong Duong aims to identify the primary care providers (PCPs) attitudes towards the
communication received from four tertiary hospitals (Peter Mac, Royal Melbourne Hospital, St. Vincent’s Hospital, and Western Health). Although the care of cancer patients has
shifted towards a multidisciplinary model, current evidence still highlights the deficiencies
of communication between specialists and PCPs. The baseline survey was completed in
June 2013, with a consensus meeting organized for mid-September. The discussions
from this meeting will ultimately inform the next stage (intervention), which involves modification to the MDT or Outpatient letter templates, and the method of communication to
the PCPs.
Development and pilo ng of a model of care for the follow up of cancer survi‐
vors following the comple on of ac ve treatment (led by Adele Mollo, WH) This two year project was initiated at Western Health in early 2012 with the main objective
to develop, pilot and evaluate a pathway for the follow-up of colorectal cancer survivors
after completion of active treatment. The pilot aims to utilise the role of an Advanced
Practice Nurse to provide nurse-led follow-up and continuity of care, whilst establishing a
smooth transition for cancer survivors back to their community with the support of hospital
resources.
Survivorship
& Follow Up
Survivorship and follow up is a
new area of priority for WCMICS
and is now considered an essential component of cancer services
planning. Many people whose
cancer has been treated and
controlled now live for many
years after their cancer diagnosis. This calls for more attention
to be given to caring for and understanding cancer survivor
needs.
Survivorship refers to anyone
who had finished their ‘active’
cancer treatment and is living
with or beyond cancer.
The retrospective audit for follow-up of colorectal cancer patients at WH was completed in
February 2012 and preliminary observations uncovered the lack of documented communication from private rooms, blood tests not completed prior to outpatient appointment,
and the lack of evidence of supportive care screening. These findings were presented by
Project Officer Ilana Hornung at the inaugural VICS 2013 Conference (see page 16).
Next steps include the development of a Follow-up Care Plan and a Collaborative Followup Patient Pathway. A Colorectal Advanced Practice Nurse has been employed since
June 2013 to pilot the colorectal follow-up pathway and the project team looks forward to
reporting the pilot findings towards the end of December 2013.
www.wcmics.org/survivorship
WCMICS Annual Report 2012/13
15
Inaugural VICS Conference 2013
The Inaugural Victorian Integrated Cancer Services two day Conference was held on 13 and 14
May 2013 at Rydges Melbourne Hotel. The organising committee were given a challenge due to the
short timeframe in which they had to organise the
conference. Despite this, the conference delivered
its objectives:
•
Promote and share the work of the ICS
•
Engage with a wider audience including medical professionals and consumers
•
Invite speakers who would engage and inspire
health professionals
•
Provide opportunities for consumers to share
both in the learning opportunities and in consumer initiated work programs
•
Incorporate a specific supportive care day to
negate the need for a separate forum
•
Provide a networking opportunity
Plenary session
16 WCMICS Annual Report 2012/13 David Binns
The conference was well attended with 274 delegates over the two days from a range of health
professionals and consumers already involved
with the ICS, but more importantly it was able to
showcase the work of the ICS to a wider audience.
An extensive program was on offer with Day One
highlighting innovation in research, service delivery and models of care. Day One concluded with
a social function to promote networking. Day Two
focussed on supportive care, including survivorship care, again demonstrating a range of work in
this growing area and was very pertinent to consumers who were in attendance. Both days provided a platform for discussion, debate and networking.
WCMICS was well represented with five oral
presentations and eight posters showcasing
WCMICS funded projects. We also had a good
range of clinicians who attended as well as five
consumers.
Dr Adrian Dabscheck
WCMICS Oral PresentaƟons
WCMICS Poster PresentaƟons
The development of a SMART
(Symptom Management and Referral
Team) Clinic to support patients and
carers.
Dr Adrian
Dabscheck
Can we improve the care of older
people with cancer through targeted
supportive care assessment; capacity building and partnerships with sub
acute ambulatory care services?
Dr Carrie
Lethborg
Improved patient care through the
introduction of a Radiation Oncology
dedicated PET/CT (Positron Emission
Tomography/Computed Tomography)
service.
David
Binns
Development and implementation of
a local consensus statement for gastrostomy tube insertion in head and
neck cancer patients
Jenelle
Loeliger
Colorectal Collaborative Follow-Up
Model of Care at Western Health
Ilana
Hornung
Sustaining supportive care through
staff, patients and carer empower-
Angelina
Cutri
Implementation of MDM Software at
Western Health
Dr Dishan
Gunawardana
Implementation and Review of an
Enhanced Recovery after Surgery
Program within a Tertiary Cancer
Hospital
Yvette
Console
Using Data for Western Health Haematology Service Analysis
Kathy
Hendry
Perceptions and attitudes to early
integration of palliative care for patients with incurable lung cancer:
results of a survey
Katie
Doan
Development and implementation of a
novel nutrition support program to
improve the nutrition care of ambulatory patients in the chemotherapy day
unit
Jenelle
Loeliger
Developing a performance data suite
to facilitate lean improvement in a
chemotherapy day unit.
Danielle
Murray
Is early integration of palliative care
for patients with incurable lung cancer
acceptable to Australian healthcare
professionals?
Katie
Doan
“The resounding feedback from the delegates was that the program content and relevance
exceeded their expectaƟons and that there was significant interest in future events.”
WCMICS Annual Report 2012/13
17
WCMICS Sharing Event 2012
On 27 November 2012, WCMICS held its first
Sharing Event at Graduate House, The University
of Melbourne. The theme of the day was ‘Working
as One’ and it provided a local opportunity to
showcase the service improvement activities undertaken throughout WCMICS during the year.
Par cipant Feedback WCMICS asked attendees what they thought of our first Sharing
Event. Overall satisfaction ratings were high and complimentary of
the quality of presentations provided. Specific comments included:
“Best version of a year in review - more of the same”
Thirteen presentations were provided by WCMICS
funding grant recipients and colleagues in front of
an audience of nearly 100 people (consisting of
mainly nursing, allied health and other ICS representatives). The day was deemed a success by
those who participated and WCMICS will be hosting subsequent ‘Year in Review’ Sharing Events
over the years to come.
Opening address: Jenny Byrne, WCMICS Manager
18 WCMICS Annual Report 2012/13 “Excellent variety of projects, even those from different disciplines
and patient groups were relevant’”
“Elements of almost everything can be applied to our work place”
PresentaƟons
Nurse led Breast Clinics
Danielle
Spence
SMART clinic - symptom assessment and referral team
Dr Karin Thursky, PMCC
Improving nutrition for Chemotherapy patients
Jenelle
Loeliger
Adolescent and Young Adult
Cancer Network
Louise
Devereux
Multidisciplinary meeting software implementation
Dr Dishan
Gunawardana
MBS billing of multidisciplinary
meetings
Lesa
Stewart
Building business cases for
care coordination
Data usage for cancer service
planning
Adele Mollo, WH
Haematology
ping
Service
Map-
The management of low risk
febrile neutropenic patients
Patients requiring Gastrostomy feeding
End of life care pathways elearning
Jenelle Loeliger, PMCC
Dr Adrian Dabscheck
& Fran Gore
Supportive Care
Implementation
Screening
Katy
Weare
Adele
Mollo
Dr Duncan
Carradice
Angela Mellerick &
Dr Karin Thursky
Fiona
Rezannah
Dr Natasha
Michael
Angelina
Cutri
WCMICS Annual Report 2012/13
19
Chemotherapy Community of PracƟce
Following two successful CDU redesign projects
funded by WCMICS in 2010/11, the Department
of Health invited expressions of interest from Victorian public health services for funding to undertake a local CDU redesign project. The aims were
to help manage CDU capacity, to help reduce wait
times, and to improve efficiency and performance.
A total of eight health services were successful in
attracting this funding (including Western Health
from within the WCMICS region). To assist these
teams and all other interested Victorian CDUs to
meet and exchange ideas, WCMICS established
a community of practice.
This statewide group met on two occasions during
2012/13 with themed sessions enabling sharing of
ideas. The first community of practice discussed
chemotherapy education with guest speakers
from Peter Mac and Western Health. The second
session looked at pharmacy practices throughout
the state with guest pharmacy speakers from
Warragul, Leongatha, The Women’s and Peter
Mac. A third session is planned for the second
half of 2013 which will highlight patient support
between treatment including after hours phone
calls and triage. During all of these meetings there
has been an opportunity for the Department funded project teams to report on their progress to
date whilst enjoying the opportunity to network
and share approaches and ideas the with wider
CDU group.
If anyone would like to attend future meetings of
this community of practice they are more than
welcome and should contact the WCMICS Directorate. Please refer to our website for contact
details: www.wcmics.org
20 WCMICS Annual Report 2012/13 Pictured above: Images from the first two community of practice
sessions
Consumers
Consumer Involvement in the WCMICS Funding Program The WCMICS Funding Program 2012/13 was the first time our consumers had been involved in a structured way in deciding
which potential projects should be awarded funding.
Consumers were asked for their input at the full application stage of the process. Applications were distributed amongst the ten
consumers, with each consumer getting three or four projects to review. Their feedback was provided on a template which asked
specific questions about each section of the application and also provided space for additional comments. The feedback was
collated and provided to a consumer representative who sat on the final evaluation panel and added the consumer views into the
panel’s considerations.
The consumer who sat on the final evaluation panel, John Preston, was interviewed about his experience of this process:
Was the format of the consumer input appropriate? How about the timescale?
“The format was fine with me. I was able to take on the feedback from the other consumers and add my own opinions as well.
The timescale was okay for me but I think some of the other consumers maybe needed more time to get their thoughts down on
paper.”
What were your experiences of the funding panel meeting?
“It’s a difficult process but it was well disciplined and discussions were focused, non-biased and subjective. There was a good
collaborative atmosphere – people were happy to share their work between sites to
ensure the greatest benefit for patients.”
Did you feel the opinions of consumers were heard?
“Yes, definitely. Each member of the panel was given the chance to give their
thoughts and I was treated like any other person around the table. There was a good
mix of clinical and non-clinical staff so more technical issues were well explained for
those who weren’t experts in the area. All my questions were answered fully.”
Would it be better to provide the written consumer feedback directly to the funding panel?
“No. I think this way works better because it’s a more effective use of the panel’s time.
Often the points raised by consumers were the same as other members of the panel
so it wasn’t always necessary to quote the written feedback. I would just say that the
consumers agreed.”
John Preston, Consumer
WCMICS Annual Report 2012/13
21
WCMICS Funding Program
The WCMICS Funding Program supports Tumour Group and hospital service improvement projects aligned to the
objectives of the WCMICS Strategic
Plan 2012-15, VCAP and other pertinent
WCMICS strategies. Nine projects were
funded in 2013 under the categories of:
WCMICS Funded Projects 2012/13
•
Integrated & Patient Centred Care
(Priority Area 1)
•
Information Management & Technology (Priority Area 2)
•
Supportive Care (Priority Area 3)
•
Survivorship & Follow Up (Priority
Area 4)
Further information on all WCMICS
activities is available on our website www.wcmics.org
Towards a modern prospective database for haemopoietic stem cell transplantation.
Priority Area 2
Palliative Radiotherapy Rapid Access Clinic (PRRAC)
- Pilot project to assess clinic implementation and
patient outcomes.
Priority Areas 1 & 3
Implementation of a clinical pathway for the management of neutropenic fever.
Priority Areas 1, 2 & 3
Development and promulgation of safe handling and
distribution guidelines for "new" anticancer molecules
by hospital personnel including pharmacy, nursing
and medical personnel.
Priority Area 1
Development of an innovative nursing workforce
strategy to manage service expansion and growth.
Priority Areas 1 & 3
Implementing a best practice pathway for Advanced
Breast Cancer (ABC) patients .
Priority Areas 1 & 3
A pilot study examining the feasibility and utility of
incorporating a screening geriatric assessment questionnaire (sGAQ) into discussion at multidisciplinary
cancer meetings for patients ≥70.
22 WCMICS Annual Report 2012/13 Category
Priority Areas 1 & 3
Development and implementation planning of clinical
practice guidelines for the prevention of thromboembolism (TE) in patients with cancer undergoing major
surgery.
Priority Area 1
Establishment of a clinical liaison nurse model with
the Chemotherapy Day Unit (CDU) at the Royal Melbourne Hospital; by facilitating a coordinated approach to the cancer patient’s treatments within the
CDU for all tumour streams and with internal / external agencies.
Priority Area 1
Governance Structure & CommiƩees
WCMICS Structure The WCMICS work program is overseen by the WCMICS Governance Committee and assessed using the agreed
measures identified in the WCMICS Strategic Plan 2012-15 and pertinent VCAP targets. The following diagram outlines
the governance structure within the WCMICS.
The WCMICS Governance Committee provides broad oversight, direction and leadership to WCMICS, complimentary to
that of the Director, Manager and the Clinical Management Advisory Committee (CMAC).
The role of CMAC is to be WCMICS’ key resource of expert clinical advice to provide support to the WCMICS Directorate and the Governance Committee on the implementation of VCAP and the WCMICS Strategic Plan 2012-15.
The Supportive Care Advisory Group (SCAG) was established in late 2007 to oversee the implementation of the
WCMICS Supportive Care Strategy. SCAG is comprised of members from across the WCMICS with relevant expertise
and experience.
Consumer Partnerships Group WCMICS Tumour Groups are established for all ten tumour streams. The Tumour Groups consist of medical, nursing
and allied health members from across all member organisations who provide leadership, knowledge and expertise
related to each tumour stream. Five Tumour Groups have an agreed work program and are currently working on activities prioritised within the WCMICS Strategic Plan 2012-15.
Department of Health Cancer Strategy and Development Victorian ICS Network Group WCMICS Directorate Director, Manage and Project Officers WCMICS Governance Commi ee WCMICS Clinical Management Advisory Commi ee Suppor ve Care Advisory Group Tumour Groups WCMICS Annual Report 2012/13
23
Our CommiƩees & Groups
Governance Commi ee (as at June 2013)
Clinical Management Advisory Commi ee (as at June 2013) A/Prof. Alex Cockram, Chair, CEO
Western Health
Prof. Michael Green, Chair
Western Health / Melbourne Health
Ms Rhonda Beattie-Manning
Western Health
Ms Adele Mollo
Western Health
Prof. Patricia O’Rourke, CEO
St Vincent’s Hospital Melbourne
Ms Sue Kirsa
Peter MacCallum Cancer Centre
Mr Andrew Crettenden
St Vincent’s Hospital Melbourne
A/Prof. Boon Chua
Peter MacCallum Cancer Centre
Prof. Bob Thomas, Acting CEO
Peter MacCallum Cancer Centre
A/Prof. Sandy Heriot
Peter MacCallum Cancer Centre
Mr Shane Ryan
Peter MacCallum Cancer Centre
Mr Phillip Antippa
Melbourne Health / Peter MacCallum Cancer Centre
Dr Linda Mellors
Werribee Mercy Hospital
A/Prof. Karin Thursky
Peter MacCallum Cancer Centre
Dr Jack Bergman
Werribee Mercy Hospital
A/Prof. Kate Drummond
Melbourne Health
Ms Dale Fisher, CEO
Royal Women’s Hospital
Dr Alex Clinch
Melbourne Health
Ms Nicole Tweddle
Royal Women’s Hospital
Ms Sue Rice
Melbourne Health
Dr Gareth Goodier
Melbourne Health
Prof. Bruce Mann
Royal Women’s Hospital / Melbourne Health
Ms Diane Gill
Melbourne Health
Dr Anthony Dowling
St Vincent’s Hospital Melbourne / Werribee Mercy Hospital
Mr John Preston
Consumer
Dr Carrie Lethborg
St Vincent’s Hospital Melbourne
Prof. Michael Green
Chair CMAC
A/Prof. Ray Snyder
St Vincent’s Hospital Melbourne
Director and Manager ex officio
WCMICS
Ms Lesa Stewart
St Vincent’s Hospital Melbourne
Ms Gillian Evans
Werribee Mercy Hospital
Director and Manager ex officio
WCMICS
24 WCMICS Annual Report 2012/13 Support Care Advisory Group Tumour Groups (as at June 2013)
(as at June 2013)
Ms Katy Weare, Chair
Royal Women’s Hospital
Dr Lesley Stafford
Royal Women’s Hospital
Dr Carrie Lethborg
St Vincent’s Hospital Melbourne
Ms Genevieve O’Neill
Melbourne GP Network
Ms Jessica Holman
Melbourne GP Network
Ms Alison Hocking
Peter MacCallum Cancer Centre
Dr Brian Le
Melbourne Health
Breast
Ms Meron Pitcher (Chair)
Western Health
Upper Gastrointestinal
Mr Gary Crosthwaite (Chair)
Melbourne Health
Haematology
Mr Simon Harrison (Chair)
Peter MacCallum Cancer Centre
Head & Neck
Mr Bernard Lyons (Chair)
St Vincent’s Hospital Melbourne
Lung
A/Prof. Ray Snyder (Chair)
St Vincent’s Hospital Melbourne
A/Prof. Kate Drummond
Melbourne Health
Ms Kath Quade
Victorian Comprehensive Cancer Centre
Dr Grey Searle
Western Health
Ms Sandra Jess
Werribee Mercy Hospital
Ms Susana Dovale
Werribee Mercy Hospital
Ms Rachael Ryan
Consumer
Director and Manager ex officio
WCMICS
WCMICS Annual Report 2012/13
25
Financial Report
For the year ending 30 June 2013
Income 2012/13
$ Department of Health - Grants
1,810,036
VICS Conference Funds**
24,460
Brought forward from previous year
53,567
Commitments from 2011/12
45,000
Income Total 1,933,063 Expenditure Salary and Wages - Basic
- Salary on costs
Salary and Wages Total 666,170
68,640
734,810 Directorate Operating Costs
19,239
Host Agency facilities
95,560
Strategic Plan Implementation
VICS Conference Funds**
Committed funds
Hospital based staff*
746,293
7,874
45,000
245,854
Total Expenditure 1,894,630 Surplus 38,433 VICS Conference Funds**
16,586
DH Priorities
18,042
WCMICS Surplus Funds
3,805
*administrative coordinators
**Host ICS for VICS Conference 2013
26 WCMICS Annual Report 2012/13 Future DirecƟons: 2013/14 & Beyond
The WCMICS work program will continue to be based on the overarching goals of VCAP and the WCMICS Strategic
Plan 2012-15. 2013/14 will see the continuation of a number of a number of key pieces of work including patient pathways for all ten tumour streams and the implementation of the resulting recommendations.
Objectives for 2013/14 include:
•
Supporting health services to improve cancer service provision
•
Continuing quality activities
•
Expanding links and collaborations within and outside of WCMICS via joint initiatives
•
Continuing to support Tumour Group and hospital based service improvement activities via the WCMICS Funding
Program
•
Building closer working relationships with the VCCC
•
Continuing to explore links with the private sector
•
Continuing to implement and evaluate the WCMICS Consumer Partnerships Work Program
•
Exploring WCMICS role in research
WCMICS looks forward to working with our WCMICS region and statewide colleagues to progress these objectives in
2013/14.
WCMICS Annual Report 2012/13
27
Our Team
Jeff Szer Di Saward Director
[email protected]
Senior Project Officer
[email protected]
Jenny Byrne Michael Barton Manager
[email protected]
Project Officer
[email protected]
Alexandra Johnston Allen Foo Cancer Services
Improvement Manager
[email protected]
Project Officer
[email protected]
Belinda Thomas Information Manager
[email protected]
- maternity leave December 2012
Steven White Information Manager
[email protected]
28 WCMICS Annual Report 2012/13 Andreia Sismanis Administrative Assistant
[email protected]
- left June 2013
Acronyms
CCV
The Cancer Council Victoria
CDU
Chemotherapy Day Unit
CMAC
Clinical Management Advisory Committee
DH
Department of Health
ERAS
Enhanced Recovery After Surgery
ICS
Integrated Cancer Service
ICT
Information and Communication Technology
LOS
Length of Stay
MDM
Multidisciplinary Meeting
MDT
Multidisciplinary Team
MH
Melbourne Health
PCPs
Primary Care Providers
PMCC
Peter MacCallum Cancer Centre
RMH
Royal Melbourne Hospital
RWH
Royal Women’s Hospital
SCAG
Supportive Care Advisory Group
SVHM
St Vincent’s Hospital Melbourne
TE
Thromboembolism
VAED
Victorian Admitted Episodes Data Set
VCAP
Victorian Cancer Action Plan
VCCC
Victorian Comprehensive Cancer Centre
VICS
Victorian Integrated Cancer Services
WCMICS
Western & Central Melbourne Integrated Cancer Service
WH
Western Health
WMH
Werribee Mercy Hospital
Further information about WCMICS and completed
projects/activities can be obtained from the
WCMICS website:
www.wcmics.org
The Directorate can be contacted on:
(03) 9656 2789