Background
Improving the timeliness and pathways of care for cancer patients through the implementation of the Optimal Care Pathways (OCP) is a focus for the Victorian Department of Health & Human Services (DHHS). Implementing the Oesophagogastric (OG) OCP has occurred over three key phases: Identifying variations in care at the OG Victorian Tumour Summit, further refinement and problem identification via the Victorian OG cancer audit, and implementing the Oesophagogastric Cancer-Service Redesign Program (OG Redesign) to address variations in care.
Aim
OG Redesign addressed two identified variations by:
Methods
Eight Victorian health services participated in OG Redesign. Engaging local clinicians and administrators to design solutions to address identified gaps was a key strategy of the project. Data was collected on all newly diagnosed cases of OG cancer referred to health services and evaluation was undertaken using the ReAIM Framework, incorporating qualitative and quantitative data. The Victorian OG cancer audit provided baseline data.
Results:
From January 2018 to 31 May 2019, 590 newly diagnosed OG cancer cases were identified by participating health services. MDM presentation rates increased from 81% to 91%. At baseline 63% of people received their first treatment within 42 days of receipt of referral, increasing to 70% for people diagnosed in 2019. Streamlining processes to manage referrals, diagnostic and staging tests, communication between clinicians and health service departments, and MDM presentation and referral processes facilitated project outcomes.
Conclusion:
OG Redesign finished on 30 June 2019. System change takes time and activities implemented to achieve objectives continue to be embedded. Future auditing will determine the long-term sustainability of Program outcomes. OG Redesign provides an example of a state-wide approach to improving cancer care.