Aim:
The South Australian (SA) Cancer Survivorship Framework facilitates equitable access to survivorship care across the state. This study aims to review the implementation of the Framework in a regional cancer service.
Method:
Mt Gambier District Health Service (MGDHS) regional cancer service was identified as a champion site for pre-implementation pilot of the Framework in early 2016. This required service reorientation to provide individualised treatment summary, needs assessment and care planning to cancer patients completing adjuvant therapy. The local team engaged with metropolitan counterparts to learn from and further refine process and templates with the view to continuation and expansion of practice beyond the pilot.
Results:
Since commencement, 34 patients completed adjuvant chemotherapy in MGDHS. Of these 28 (82%) attended a Survivorship Clinic appointment with similar projections for 2018. Implementation of the survivorship framework was delivered with no additional resources. Its success was dependent on a committed oncology team who re-prioritised workload to include survivorship care. Smaller numbers of clinicians and patients involved made for a simpler process and more manageable workload demands, as well as integration to a larger statewide process. Challenges included the streamlining of workflow and timely access to clinical information. Patient feedback during the pre-implementation pilot showed value in the treatment summary and care plan and further evaluation of both the patient and GP experience is planned.
Conclusion:
Embedding survivorship care into a regional cancer service has been possible through a stepwise approach to implementation of the statewide Framework. This phased approach can be utilised to support planning and implementing in other regional cancer services.