Transcript Slide 1

Non-surgical Cancer
Treatment Services
Medical Oncology Models of Care
Overview of the three implementation programmes
1. Service configuration - To help improve and
reconfigure services and to increase treatment
capacity in the appropriate facilities
2. Workforce - To develop and support workforce models
that increase clinical capacity
3.
Service quality - To improve clinical quality and
service efficiency so that patient care is equitable
nationwide
Medical Oncology Models of Care
Developments to date include:
• development, distribution and analysis of a service
assessment tool for DHBs
• development of regional oncology service plans
• appointment of a project team, including two Senior
Medical Officers (SMOs), to develop guidance on
alternative clinical and non-clinical roles in medical
oncology
• appointment of a clinical nurse lead to develop a
Knowledge and Skills Framework for Cancer Nursing
Medical Oncology Models of Care
2013/14 activities:
1. The service configuration programme
• Develop national standards for the delivery of medical oncology
services to support a four level service centre model of care.
2. The workforce programme
• Develop guidance on alternative clinical and non-clinical roles in
medical oncology.
• Develop a Knowledge and Skills Framework for Cancer Nurses that
will include:
specific nursing activities/tasks and competencies at each stage of the patient
care pathway
– an education programme for cancer nursing.
–
• Begin implementation of the Knowledge and Skills Framework for
Cancer Nurses.
Medical Oncology Models of Care
2013/14 activities:
3. The service quality programme
• Support the implementation of the national standards for tumour
specific treatment.
• Support quality improvement initiatives such as multidisciplinary
meetings.
• Support the regional cancer networks to implement their regional
service plans.
• Support the sector to implement and share service innovations.
Chemotherapy E-Prescribing Project
Project purpose
To progress the development of eprescribing for chemotherapy in the CCN
region as an enabler to support the
Medical Oncology Models of Care
implementation.
Chemotherapy E-Prescribing Project
Objectives:
• Regional Cancer Treatment Service (RCTS) development
of a business case and implementation plan to enable
chemotherapy e-prescribing, via MOSAIQ, with its
catchment DHBs
• Wellington Blood and Cancer Centre (WBCC) completing
a feasibility study to identify an electronic patient
management system to support their medical oncology
and clinical haematology services, taking into account
the wider context of the cancer centre and DHB
existing Information System infrastructure
•
Chemotherapy E-Prescribing Project
RCTS
• A joint project MO and CH
• Business case in development for Mosaiq
chemotherapy prescribing
• Awaiting a wireless environment and Mosaiq
mobile
• Phased implementation but planned for all
RCTS sites
• Working closely with SCN
Chemotherapy E-Prescribing Project
WBCC
• Identified as a strategic goal some years ago
• Aligns well with the national momentum
• Locally we want to identify the solution that
– Performs the key tasks to the highest level
– Allows us to interface with Radiation Oncology
appropriately
– Allows us to work regionally as effectively as
possible
– Allows us to report to National Projects to the
standards required.
•
Chemotherapy E-Prescribing Project
WBCC
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Site visits from the 3 vendors in the mix: Aria; Mosaiq
(Elekta); Charm Served to orientate staff to the project
and the questions to ask
Project Team – Representing all the disciplines
Drafting a document that tries to ask all the relevant
questions of a product – so the preferred candidate can
be identified (“RFP phase”)
Move this out to the Vendors
Review the Result with the teams
Select and justify the preferred solution – writing the
Business Case.
Chemotherapy E-Prescribing Project
Milestones
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Completed by
Project /Communication Plan and Feasibility Study Criteria
July2013
Regional Steering group and RCTS / WBCC Project Groups
established
RCTS pre-implementation activities identified and commenced
July 2013
WBCC feasibility study completed
Sep 2013
MDHB HAC endorsement RCTS Business case and implementation
plan
C&CDHB executives decision re WBCC feasibility study
recommendations
Phase 1 activities complete and Phase 2 activities identified
Oct 2013
July 2013
Oct 2013
Oct/Nov 2013
WBCC / RCTS service developments
• WBCC
• Ambulatory Model of Care and expansion
of services
• 5 North additional beds
• Outreach services
WBCC / RCTS service developments
RCTS
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Improving outpatient clinic facilities
Continue to develop 2 CNS roles for MO
Standardisation and control of protocols
Planning for future staffing numbers
Consideration of an outreach chemotherapy
model for Whanganui
Proposed Regional Activities 2013/14
• Complete Chemotherapy E-prescribing Project
Phase 1 activity by October 2013 (timing of
Phase 2 activities dependant on MDHB and
C&CDHB decisions at this point).
• Complete a short term Medical Oncology
Regional Service Plan to support the
implementation of MOMOC (under
consideration by the E-prescribing Regional
Steering Group)
Proposed Regional Activities 2013/14
• Continue to contribute to the MOMOC National
Implementation Plan activities, including:
– development of national standards for the delivery
of medical oncology services
– development of guidance on alternative clinical and
non-clinical roles in medical oncology
– development of a Knowledge and Skills framework
for cancer nurses and commencing implementation
activities
National Radiation Oncology Plan
Project Purpose
To develop a robust National Plan that will
inform national-level decision making,
and provide guidance for further more
detailed capacity and operational
planning, and the parameters and tools
to assist DHBs’ local and regional
planning processes for radiation oncology
services in NZ over the next 10 years.
National Radiation Oncology Plan
Involves drawing together:
• existing detailed planning of radiation
oncology services
• forecasting models for cancer prevalence
and regional linear accelerator capacity
needs
• additional workforce and cost modelling
to be undertaken
National Radiation Oncology Plan
Milestone
Completed by (2013)
Development and testing of modelling
assumptions and parameters
30 April
Report on modelling (linear accelerators,
workforce, cost)
31 May
Stakeholder engagement on draft plan
26 August – 13 September
Final Plan completed
31 October
Ministry of Health publication of Final Plan
December
WBCC / RCTS service developments
WBCC
• 2012 regional LINAC requirements were reviewed in
conjunction with Mid-Central
• 2011 as base yr and modelled to 2020
• population, intervention rates, retreatment rates
• Average number of fractions, linac available hours,
built in coping with peak demand and still meeting 4
week target
• Modelled change in complexity on linac throughput
WBCC / RCTS service developments
WBCC
• need 4th LINAC 2014 and a second in 2019/20
• National Service Plan – using a similar approach
(but not building in a change to average
treatment times for complexity) yet to be
released - due later this year and therefore
likely to stall 4th LINAC and associated facilities
along with the fiscal constraints of the hospital
and the complexity of a North End development
WBCC / RCTS service developments
WBCC service developments for 2013/14:
• Facilities and Equipment:
• Replacement LINAC 1 business case
• 4th LINAC and facilities expansion
• Utilisation of old simulator room
• Participation in dept wide review of
ambulatory care and e prescription
• ARIA upgrade
WBCC / RCTS service developments
WBCC – Brachytherapy service
• U/S based planning for HDR prostate
• Interstitial needle use for some cervical
carcinomas
• Interstitial breast HDR
• (Endoluminal service)
WBCC / RCTS service developments
WBCC
• continue to extend our review of patient
immobilisation and imaging.
• numerous physics projects – acuros dose
calcs, safety plans, in vivo dosimetry,
new TBI protocol
• Radiation therapist projects focused on
patient education/care, quality/process
improvement,IT supported oncology care
WBCC / RCTS service developments
RCTS
• Replacement of simulation CT scanner
• Optimising the work flow area
• Stereotactic body radiotherapy program
• Initial work on linac vendor change
Proposed Regional Activities 2013/14
• Participation on National Radiation Oncology Plan
Steering Group and Expert Advisory Group through to
October 13.
• Development of a Regional Radiation Oncology Services
Implementation Plan by June 2014.