BACKGROUND: The Head and Neck multidisciplinary team identified potential gaps in post-treatment care for patients receiving radiotherapy at the Peter Mac Moorabbin ’satellite‘ campus.
AIM: To identify unmet needs and develop strategies for improving access to survivorship care.
METHODS: Service evaluation and process mapping included: 1)identification of gaps in service delivery, as compared to the Head and Neck Optimal Care Pathway and Victorian Quality Cancer Survivorship Care Framework; 2)semi-structured interviews with clinicians regarding perceived gaps to best practice and optimal care; 3)audit of routinely collected supportive care screening tool to identify the most common concerns pre-treatment; 4)survey of previously treated patients using a study-specific questionnaire to identify unmet survivorship care needs; and 5)a review of local external supportive care services.
RESULTS: Routine post-treatment supportive care screening was not performed, despite Survivorship Care Framework recommendations. Gaps identified by clinicians include access to onsite psychology, sleep, chronic pain and return to work support. Supportive care screening tool audit (n=116), revealed the main concerns pre-treatment were: transport, insurance and finance, worry, nervousness, pain, sleep and fatigue. Surveys from 30 patients, 3-18 months post-treatment, identified gaps in information provision for: documented care plans, sexual health, finance, pain management, psychology and support groups. Only 33% of patients were “very confident” to manage their own needs, and 47% had confidence their GP could provide follow-up care. Community, non-profit and external government services were identified to provide finance, peer support, well-being, and psychology care.
CONCLUSIONS: Nine key recommendations were developed, leading to Peter Mac allocating senior medical staffing resources to develop a local survivorship care procedure. This work will investigate elements of workforce re-design, improving data collection and outcome measures, treatment discharge plans and accessing appropriate external services. We anticipate any changes will provide meaningful and measurable improvements in the delivery of quality care.