VICS Optimal Care Summits consultation process

Each strategic consultation delivered by the VICS Optimal Care Summits program focuses on a specific cancer type (‘tumour stream’), priority population, or step of the Optimal Care Pathways (OCPs).

Topics are chosen in consultation with the Victorian Department of Health, based on:

• familiarity – Repeat summits can discuss data and changes in the years since we last held a summit on the same topic
• variations in care or outcomes across geographical regions of Victoria and/or Socio-Economic Indexes for Areas (SEIFA) that merit investigation
• the number of Victorians affected, and their survival rates
• momentum for existing policy and program areas, such as palliative care and advance care planning or tumour types targeted by screening programs
• priority populations that align with state and national cancer plans such as Aboriginal and Torres Strait Islanders, and people with a disability
• priority OCP steps that connect unwarranted variations common to multiple tumour streams and/or priority populations, such as delays to diagnosis (OCP step 3) or starting treatment (OCP step 4).

For the selected cancer type, population or OCP step, each of our geographically-based Integrated Cancer Services (ICS) then establishes a local expert advisory group. These groups comprise a wide range of healthcare providers, leaders and stakeholders involved in that area of cancer care. These can include oncologists, surgeons, GPs, palliative care specialists, nurses, allied health professionals, lived and living experience partners, and more.

For each strategic consultation, the VICS also establish a stakeholder register of interested multidisciplinary clinicians who will be engaged in advisory groups, surveys, live summit events, and/or communications.

Linked data on variations in care and patient outcomes are accessed from some or all of:

• Victorian Admitted Episode Dataset (VAED)
• Victorian Cancer Registry (VCR)
• Victorian Emergency Management Dataset (VEMD)
• Victorian Radiotherapy Minimum Dataset (VRMD)
• Notifiable infectious diseases – Public Health Event (PHESS)
• Victorian Health Care Experience Survey (VHES)
• Victorian Integrated Non-Admitted Health Dataset (VINAH)
• Cancer Service Performance Indicators (CSPI)
• Statewide Cancer Indicator Platform (SCIP)
• Primary care data (if available)
• Cancer clinical registries (if available).

The expert advisory groups establish and endorse an analysis plan, including what indicators to examine within each dataset.

The VICS Optimal Care Summits team investigates what is already known about patient experience and outcomes in the selected area of cancer care, via an online scan of existing material and a survey of stakeholders. The team also develops a literature review register to capture the evidence base and key implications of published manuscripts. This register helps us to identify:

• known patterns of care with an Australian setting
• approaches to determine and/or address unwarranted variations
• effectiveness of previous improvement approaches.

The VICS Optimal Care Summits team engages and consults with past and present patients, their carers and family members (collectively, ‘consumers’ or ‘lived and living experience partners’) through interviews and focus groups to highlight their lived experience. Read more about consumers’ experience of these contributions here. We publish a patient experience report, based on the findings of this consultation.

A statewide survey of multidisciplinary stakeholders (the stakeholder register developed in step 2) explores barriers, enablers, and preferences for optimal care. For each VICS Optimal Care Summits consultation, we publish a barriers and enablers report on the findings of that survey.

From the sources above, we identify ‘unwarranted variations’ in cancer care, patient experience, and/or outcomes by ICS region. An unwarranted variation is a difference in use of health services or in patient outcomes that is not explained by differences in patient illness or preferences. That is, an opportunity to improve the quality and equity of care.

Through further stakeholder consultation, using a 3-step Delphi survey process, we prioritise unwarranted variations for action and discussion at our live summit event.

Around 100 key stakeholders from a range of disciplines and key organisations from across Victoria, including lived and living experience partners, are invited to each VICS Optimal Care Summit live event. They discuss the top 3 unwarranted variations – identified and prioritised by the consultation above – then codesign strategic quality improvement initiatives that could usefully address those variations at local and/or statewide levels.

Each of our geographically-based Integrated Cancer Services (ICS) then leads engagement with their member health services – to help local stakeholders understand unwarranted variations in care and outcomes, and to lead improvement activities to address them.

After each live summit event, the VICS publish a full list of the unwarranted variations in cancer care, patient experience, and/or outcomes identified by the consultation. You will find a list of the variations identified by each consultation, and which were prioritised for discussion at the summit event, in the relevant VICS Optimal Care Summits consultation project record.

Each Integrated Cancer Service (ICS) engages their Governance Committee and other local patient safety and quality committees, to support their understanding of unwarranted variations and guide where ICS and/or cancer service resourcing should be allocated to address them.

After each summit, a VICS Optimal Care Summit Improvement Plan summarises the codesigned solutions, improvement priorities identified at the summit, and endorsed initiatives to address the unwarranted variations. Each improvement plan is informed by evidence and insights from the steps above.

These improvement plans are published on our website and linked to from within each VICS Optimal Care Summits consultation project record. They then inform development of local ICS and/or VICS project plans.

Once we understand how the unwarranted variations and priorities from a consultation apply to each part of Victoria, the VICS and each constituent Integrated Cancer Service (ICS) support our member health services and other stakeholders to implement the initiatives in our VICS Optimal Care Summit Improvement Plan and local projects informed by that plan.

Implementation of VICS Optimal Care Summits Action Register initiatives within each Integrated Cancer Service (ICS) region is captured through that ICS’ local workplan. The VICS Optimal Care Summits team collects that information as evidence of progress against each consultation’s priorities.

As initiatives from the VICS Optimal Care Summits Action Register are implemented, we examine subsequent data from the datasets above to see what reductions are achieved in the unwarranted variations. Those improvements are mapped to relevant goals and actions within the Victorian Cancer Plan.