Promoting supportive care
Mandarin living with cancer education program
Cancer Council Victoria, Monash Health and SMICS collaborated to adapt the Living with Cancer Education Program (LWCEP) to encompass Chinese culture and the Mandarin language. Interpreters from Monash Health and consumers assisted and informed the development of the Mandarin LWCEP. Key achievements in 2019–20 included the following:
- A focus group convened on 18 November 2019 to inform the program’s development, with 11 Mandarin-speaking/Chinese participants involved.
- Supported by interpreters, participants assisted in adapting the LWCEP to encompass the Chinese community’s language, cultural and support needs.
- LWCEP in Mandarin has been developed and is ready for delivery.
- Mandarin-speaking interpreters, doctors and nurses have agreed to deliver the program.
Delivery has been delayed due to the COVID-19 health emergency. When this program is able to be delivered, the Chinese community will be better informed about their cancer care and will have a better experience of care.
Supportive care refresh project
The integration of supportive care into routine cancer care is defined as a characteristic of optimal service provision in the Victorian cancer plan and the optimal care pathways. The Supportive Care Refresh Project aims to improve supportive care practices across SMICS member health services by: building workforce capacity to identify and address supportive care needs; embedding supportive care into routine cancer care; strengthening referral pathways to appropriate services; and facilitating self-management utilising the WeCan resources.
In partnership with key stakeholders at The Alfred, Monash Health and Cabrini, SMICS began implementing the Supportive Care Refresh Project to improve supportive care screening, assessment and timely referral to appropriate services throughout the care pathway. Project implementation was delayed due to the COVID-19 pandemic, with an expected decrease in supportive care screening during this time. As the project restarts, the impact of COVID-19 on supportive care and opportunities for improving future care will be considered. In addition to improving patients’ experience of care and outcomes, this project will assist member health services to achieve the Department of Health and Human Services’ target of supportive care screening of 80 per cent of newly diagnosed cancer patients.
Study into the effectiveness and delivery of pre-treatment education at Cabrini Health for patients receiving cancer therapy
A research project was undertaken to determine the variation in content and delivery by nurses when providing pre-treatment patient education to treatment naïve patients receiving systemic cancer therapy at Cabrini Health. The views and perspectives of patients receiving the pre-treatment education were also examined to better understand their experience, retention of information and whether unmet supportive care needs of patients were being addressed.
22 patient education sessions were audited via direct observation and 14 patient questionnaires completed.
A final project report was endorsed and recommendations accepted by the Director of Medical Oncology, CDU/Oncology Nurse Unit Managers and Nursing Director Medical Services. These included targeted in-service staff training; establishing stronger links with allied health services; developing a checklist for nurses that directs discussion; and the implementation of a SURC. An action plan has been developed to implement the recommendations to support the delivery of consistent, relevant and value-based information for patients receiving systemic cancer therapy at Cabrini.
Sustaining colorectal cancer survivorship care at Monash Health
of participants reported feeling confident with GP follow-up
of patients who reported ongoing problems received support to manage them
of people received combined care for colorectal cancer and an additional comorbidity in a single GP consultation
A three-year pilot of colorectal cancer shared care at Monash Health and Eastern Health concluded in October 2019. Funded by the Department of Health and Human Services and North Eastern Melbourne Integrated cancer Service (NEMICS), this SMICS and NEMICS partnership project provided opportunities to test a new model of care across adjacent primary care networks.
Patients treated with curative intent for stages I–III colorectal cancer were eligible for shared care. The pilot found that shared care after treatment completion is highly acceptable to patients, general practitioners (GPs) and specialists. In all, 114 of the 122 (93.4 per cent) patients agreed to shared care. All specialists agreed to participate and just two GPs opted out.
Patients reported benefits of GP involvement in follow-up care after 12 months of shared care. These were themed as reassurance, familiarity, confidence, less travel and waiting times, accessibility, detailed discussion about other health issues / cancer treatment effects, and the crucial role for GPs in overall care and referrals. In all, 97.6 per cent of patients who returned 12-month surveys reported combining cancer and other condition follow-up in a single GP visit.
Further work is needed to enable reciprocal communication between acute and primary care and to embed more systematic approaches to shared care implementation. The model has been sustained and refined at Monash Health, providing holistic support and coordinated care after colorectal cancer.