SMICS Program of Work | Victorian ICS

OCP implementaion

Supporting effective implementation of the optimal care pathway

Optimal Cancer Care Pathways aim to improve patient outcomes by facilitating consistent, safe, high quality and evidence-based care. They can be used by health services and professionals as a tool to identify gaps in current cancer services and inform quality improvement initiatives across all aspects of the care pathway.

Details regarding current SMICS OCP related projects can be found below:

Optimal Care Pathways

Patient Information Brochure for Bowel Surgery Preparation

Project Lead: Tracey Bucki

Completed: 2022

An easy English patient information brochure has been developed and translated into six additional languages to support the introduction of the Monash Health Enhanced Recovery After Surgery (ERAS) Colorectal Pathway at Dandenong Hospital. The resource will provide surgical preparation information to approximately 190 patients treated for bowel cancer per year.

Shared follow-up for women with low-risk endometrial cancer in general practice

Project Leads: Tracey Bucki

Completed: 2022

Women with low-risk endometrial cancer have a reduced risk of cancer recurrence but still require monitoring after treatment. SMICS supported the Gynae-Oncology Department at Monash Health to develop a procedure that facilitates shared follow-up care for low-risk women in general practice. Where appropriate, women will be discharged to their nominated GP for follow-up care with rapid access to specialists at Monash Health if required. For more information see the attached report and Cancer Australia’s guide for shared follow-up care of women with low risk endometrial cancer.

More information

Project outcomes

Prostate Resource Flyer
Project Leads: Tracey Bucki, Anna Maciejewski
Completed: 2022

To support access for patients to appropriate information and support at diagnosis, VICS engaged with health professionals, consumers, Prostate Cancer Foundation Australia and Cancer Council Victoria. Four resources have been identified as the ‘gold standard’ to be given to newly diagnosed prostate cancer patients. This will help avoid the variation in information provided to newly diagnosed prostate patients across Victoria, as identified at the last Prostate Tumour Summit. The resources include: the PCFA booklet Prostate cancer: a guide for newly diagnosed men; Cancer Council’s Understanding prostate cancer and Guides to best cancer care – prostate cancer; and the ‘A Common Path’ video developed by North Eastern Melbourne Integrated Cancer Service.

Flyer

VICS OCP Resources & Projects

Aboriginal and Torres Strait Islander Learning Program

Project Lead: Jenny Thresher

Completed: 2023

Update - June 2022

Project Outcomes

The Optimal Care Pathway (OCP) for Aboriginal and Torres Strait Islander people aims to decrease disparities in cancer outcomes for Aboriginal and Torres Strait Islander people. To support health professionals and services implement the OCP, we brought together Aboriginal health and liaison workers (AHLO) and cancer nurse educators from four metropolitan and regional health services to co-develop a learning package.

Lung Project

Project Lead: Geraldine Largey

Completed: 2021

SMICS collaborated with local clinicians to develop agreed solutions to data identified variations in the surgical pathway at Peninsula Health. In the six-month pilot implementation period, median time from date of referral to date of diagnosis, and date of referral to date of first curative intent surgery improved by 26% and 3% respectively.

Pancreatic Cancer Resectability Project

Project Lead: Anna Maciejewska

Completed: 2022

SMICS in partnership with North Eastern Melbourne Integrated Cancer Service (NEMICS) engaged key stakeholders to adopt the ‘International consensus on definition and criteria of borderline resectable pancreatic ductal adenocarcinoma 2017.’ A newly developed synoptic report is currently being piloted by MDTs at Alfred and Austin Health.

Brain Cancer Optimal Care pathway project

Project Leads: Anna Maciejewska, Tracey Bucki

In Progress

Project Report

Report on local initiatives to reduce variations in care as identified from the Brain Cancer Victorian Tumour Summit (VTS) held October 2020. The Brain VTS working group reviewed and prioritised variations making four recommendations. The focus at SMICS included: increasing frequency of the Neuro-Oncology MDM; formalising pathways/procedures for regional health service clinicians to attend metro MDM: and to better address the specific supportive care needs and concerns of brain cancer patients.

wellbeing&support

Improving well-being and support for all Victorians affected by cancer

Palliative Care Project at Monash Health

Project Lead: Geraldine Largey

Completed 2021

In October 2020, Monash Health established a pilot Palliative Care Virtual Clinic (PCVC) to enable virtual palliative care consultation of outpatients attending oncology clinics, whether these were being delivered face to face or by video consult via health direct or telephone. SMICS supported the interim six-month evaluation of this project. Results have been withheld pending finalisation of the project and potential publication.

Advance Care Planning at Alfred Health and Peninsula Health

Project Lead: Geraldine Largey

Completed 2021

SMICS supported the development and pilot implementation of an Advance Care Planning (ACP) Workbook Project at Alfred Health and Peninsula Health between February 2021 and October 2021. The aim of the project was to promote greater participation by oncology multidisciplinary practitioners in ACP activities.

Project outcomes

Accessing cancer care equitably using Support Services (ACCESS) project:

Project Leads: Tracey Bucki

In progress

More information

SMICS is supporting the Cancer Council Victoria to implement the ACCESS project to improve access to supportive care for people affected by cancer in Southern Melbourne. The project aims to support acute and primary health services respond to the increased demand for supportive care screening, psych-oncology and practical support during the COVID-19 recovery. Visit the Cancer Council Victoria for more information about the project and support services available.

Supportive Care Refresh Project:

Project Lead: Jodi Dumbrell

In progress

The aim of the Supportive Care Refresh project is to ensure people affected by cancer have equitable access to timely and appropriate supportive care throughout the care pathway by supporting health services to: build workforce capacity to identify and address supportive care needs; integrate supportive care screening, assessment and referral into routine practice; strengthen referral pathways and linkages to services; and assist people to self-manage supportive care needs using the WeCan.org.au resources.

VICS has partnered with the Australian Cancer Survivorship Centre (ACSC) to improve survivorship care across Victoria. The project aims to improve survivorship care by supporting health services to implement survivorship care policies; models of care; and by building capability and capacity in survivorship care. Co-design workshops are planned for early 2023 to enable improved, more consistent implementation of survivorship care plans and needs assessment tools across the state.

The Victorian Statewide Collaboration to Improve Cancer Survivorship Care:

Project Leads: Tracey Bucki

In Progress

More information

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. Delivery of the program is on hold until COVID restrictions allow.

Supportive Care: Living with Cancer Education Program (Mandarin):

Project Lead:

In progress

More information

Virtual training program for Metastatic Breast Care Nurses
Project Lead:

More information

The McGrath Foundation, Monash Health, Monash University and SMICS is piloting an innovative training program to upskill McGrath breast care nurses caring for people with metastatic breast cancer. In an Australian first, breast care nurses are participating in virtual training at the Monash Cancer Centre via a telepresence robot. The program is being evaluated to assess the effectiveness of remote learning using telepresence technology.

Publications

MEASURING KNOWLEDGE, SKILLS AND CONFIDENCE IN METASTATIC BREAST CANCER NURSING: THE CANCER NURSE SELF-ASSESSMENT TOOL FOR METASTATIC BREAST CANCER (CAN-SAT-MBC)

Kruss G, Yeganeh L, Van Huizen P, Delaney J, Mahony J, Davis H, Ernst K, Finn J, Brand G, Cook O, The Design And Development Of an Individualised Training Program For Metastatic Breast Cancer (MBC) Nursing Incorporating Remote And Onsite Learning Experiences During A Pandemic Open AccessDOI:https://doi.org/10.1016/j.breast.2022.12.029

Cancer Nurse Coordinator Community of Practice
Project Lead: Jenny Thresher
Completed 2022

Following identification of the professional and supportive needs of Monash Health cancer nurse coordinators, a community of practice was developed and implemented incorporating an education and well-being program. The impact of participation on stress, burnout, resilience, job satisfaction and mindfulness was measured and documented via an evidenced based research methodology.

More information

Workforce Development

Improving Quality Cancer Care Closer to Home through Telehealth Models in Clinical Care – Statewide
Project Lead: Jenny Thresher
In progress

The Victorian Integrated Cancer Service (VICS) Implementation Plan identifies initiatives to improve the adoption of quality cancer care closer to home by actively supporting the appropriate use of telehealth models in clinical care. This program of works will collate examples of models of care using telehealth implemented throughout the VICS partners.

Telehealth Support
Project Lead: Jenny Thresher
Completed 2022

To reduce the risk of exposing vulnerable patients and healthcare workers to COVID-19, SMICS supported oncology outpatient clinics to implement a telehealth service delivery model using the Health Direct platform. The level and type of support varied between health services, but included process mapping, documenting procedures, developing scripts to support telehealth bookings, rescheduling appointments and helping patients who required additional support accessing telehealth services. Rapid uptake of telehealth ensured continuity of care for people affected by cancer throughout the pandemic.

Monash Health Virtual Nurse-led Clinic

Project Lead: Geraldine Largey

Completed: 2021

Project outcomes

SMICS supported establishing and piloting a Telehealth Cancer Support Nurse Review Clinic (TCSN-RC) at Monash Health to enhance current oncology service provision. The TCSN-RC operated on demand from Monday to Friday during business hours. It provided a service for cancer patients from all Monash sites and was led by four experienced oncology nurses distinctively positioned to provide accurate and timely assessment, triage, education, support, and intervention to optimise management of poorly controlled treatment related symptoms at home.

COVID-19 Responses

Code Brown Support

Completed 2022

SMICS staff provided support and assistance to health care services treating patients with cancer during the COVID-19 pandemic.

VCCN COVID- 19 Cancer Network Support:

SMICS staff provide significant program management support to the Victorian COVID-19 Cancer Network (VCCN) Taskforce and expert working groups. The VCCN was established in March 2020 by the VCCC alliance and Monash Partners Comprehensive Cancer Consortium (MPCCC) in response to the challenges involved with managing cancer care amid the COVID-19 global health crisis. It aims to provide support and advice to clinicians and health care services treating patients with cancer during the COVID-19 pandemic.

Implementing a Metastatic Breast MDM - Peninsula Health:

Project Lead: Jenny Thresher

In Progress

Patients with MBC have complex, high level supportive care needs requiring a multidisciplinary approach that differs from those with early breast cancer. The MDM framework provides a standardised approach for referrals and planning for complex treatment. Whilst enabling monitoring and evaluation of performance which supports quality patient care and streamlining time poor resources.

MDM Quality: Establishment of MDM Governance Group:

Project Leads: Geraldine Largey (Monash Health), Anna Maciejewska (Peninsula Health) Jenny Thresher (Alfred Health)

In Progress

MDM Governance structures are being established and supported at Monash Health, Peninsula Health, and Alfred Health to monitor and improve MDM quality.

MDM Quality: QOOL VIC Implementation at Peninsula Health

Project Leads: Anna Maciejewska, Jenny Thresher

Completed 2021

SMICS has assisted Peninsula Health in implementing the Queensland Oncology On-Line-Victoria (QOOL-VIC) application for all oncology multi-disciplinary meetings. QOOL-VIC assists meeting preparation, and documentation and communication of essential clinical information such as diagnosis, cancer stage and recommended treatment plans.

Project outcomes

Care of the older person with cancer

Project Lead: Tracey Bucki

In progress

Download Toolkit

Scoping Project

SMICS and Hume Regional Integrated Cancer Service (HRICS) have developed the VICS Care of the Older Person with Cancer Toolkit to assist health services and ICS improve the care of the older person with cancer. The toolkit provides information to help identify and address existing barriers, examples of existing geriatric oncology services and key resources including how-to guides, education opportunities and patient resources.

Publications

Taylor C, Wagner I, Jaboury MS, Bucki MT, Srivastava R. Australian Geriatric Oncology Clinic - Characteristics of the first 220 patients, the interventions and treatment recommendations made. J Geriatr Oncol. 2022 May;13(4):530-540. doi: 10.1016/j.jgo.2021.12.015. Epub 2022 Jan 13. PMID: 35034843.

Cancer services to establish appropriate and effective referral and repatriation pathways (with a particular focus on regional and outer metro services)

Project Lead: Anna Maciejewska

In progress

Allied Health Cancer Education Day was held on 18 October at LaTrobe Regional Hospital, the event was managed by SMICS in partnership with GRICS and the Gippsland Allied Health Education Group. The purpose of the day was to facilitate interdisciplinary connections and learning for allied health clinicians caring for people with cancer, from the Gippsland region.

Improving equity of access to high quality cancer care

Improving Equity

The Victorian Integrated Cancer Services are supported by the Victorian Government

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The Victorian Integrated Cancer Services acknowledge Aboriginal and Torres Strait Islander people as the Traditional Custodians of the land and acknowledges and pays respect to their Elders, past and present. We celebrate, value and include people of all backgrounds, genders, sexualities, cultures, bodies and abilities.

Improving the quality of cancer care across
southern Melbourne

Supporting effective implementation of the optimal care pathway

Patient Information Brochure for Bowel Surgery Preparation

Shared follow-up for women with low-risk endometrial cancer in general practice

Prostate Resource Flyer
Project Leads: Tracey Bucki, Anna Maciejewski
Completed: 2022

Aboriginal and Torres Strait Islander Learning Program

Lung Project

Pancreatic Cancer Resectability Project

Brain Cancer Optimal Care pathway project

Improving well-being and support for all Victorians affected by cancer

Palliative Care Project at Monash Health

Supportive Care Refresh Project:

Supportive Care: Living with Cancer Education Program (Mandarin):

Virtual training program for Metastatic Breast Care Nurses
Project Lead:

Publications

Cancer Nurse Coordinator Community of Practice
Project Lead: Jenny Thresher
Completed 2022

Improving Quality Cancer Care Closer to Home through Telehealth Models in Clinical Care – Statewide
Project Lead: Jenny Thresher
In progress

Telehealth Support
Project Lead: Jenny Thresher
Completed 2022

Monash Health Virtual Nurse-led Clinic

COVID-19 Responses

VCCN COVID- 19 Cancer Network Support:

Implementing a Metastatic Breast MDM - Peninsula Health:

MDM Quality: Establishment of MDM Governance Group:

MDM Quality: QOOL VIC Implementation at Peninsula Health

Care of the older person with cancer

Publications

Symptom Urgent Review Clinics

Cancer services to establish appropriate and effective referral and repatriation pathways (with a particular focus on regional and outer metro services)

Improving equity of access to high quality cancer care

Improving the quality of cancer care across southern Melbourne

Supporting effective implementation of the optimal care pathway

Patient Information Brochure for Bowel Surgery Preparation

Aboriginal and Torres Strait Islander Learning Program

Improving well-being and support for all Victorians affected by cancer

Palliative Care Project at Monash Health

Implementing a Metastatic Breast MDM - Peninsula Health:

MDM Quality: Establishment of MDM Governance Group:

MDM Quality: QOOL VIC Implementation at Peninsula Health​

Improving equity of access to high quality cancer care

Improving the quality of cancer care across
southern Melbourne

MDM Quality: QOOL VIC Implementation at Peninsula Health