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DRAFT Achilles Action Plan

This document outlines a series of strategic action plans aimed at enhancing cancer care services. Initiatives include expanding chemotherapy unit hours to meet rising demand, developing care coordination roles based on established models, and creating a comprehensive plan to position the facility as an Integrated Cancer Centre to facilitate fundraising. Additional measures involve establishing formal multi-disciplinary team structures, enhancing patient selection protocols, and investigating extended hours for outpatient treatment. By fostering partnerships across medical disciplines, the goal is to improve patient outcomes and streamline cancer care services.

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DRAFT Achilles Action Plan

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  1. DRAFT Achilles Action Plan • Expand day chemotherapy unit hours of operation to manage increased demand • Business plan & Working Party • Develop care co-ordination roles using breast care model • Adapt new model based on existing urology nurse liaison role, trial then evaluate • Rename as ‘Integrated Cancer Centre’ to increase fund raising opportunities • Key Stakeholder Committee to develop strategic plan for fund raising

  2. DRAFT Cyclone Action Plan (1) • June 05: Data definitions & activity by TPL • HRT/Kespasi; confirmation by members; collect & report back to Tumour Program • Aug 04: Confirm specifications for MDJ’s and Care Co-ordination model • Define tasks, draft specification standards for MDTs X 10; confirm care co-ordination model including screening tools

  3. DRAFT Cyclone Action Plan (2) • Dec 04: Service Directory & affiliation (hard copy) – when to refer & to whom • Agree affiliation criteria (including early signs and symptoms); invite all Clinics to be listed by Tumour Program; publish annually (Westmead model) • Dec 04: Formal management & ownership of inpatients by Tumour Program • Data mapping back to Tumour Program; Business meeting to examine common elements of  admission/stays; develop cost sharing formulae • June 05: Meet CSF standards (NSW well placed to lead) • As specified

  4. DRAFT Cougar Action Plan • Develop Prostate Specialised Care Team • Get key people together - appoint lead clinician; learn from BSE program – familiarise all team members with goals/outcomes of MDT; identify resource support • Investigate need/feasibility of extended hours for Day treatment • Discuss with staff; survey patient interest in out of hours treatment; identify potential demand & opportunities for improvement

  5. DRAFT Polaris Action Plan (1) • June 04: preliminary discussion of options for surgical oncology becoming part of Cancer Services • Discuss options, operational & financial models; find attractors for surgeons – ‘what’s in it for them?” • June 05: decision of parts to include

  6. DRAFT Polaris Action Plan (2) • Establish formal MDT structure in major tumour groups (organisation, not clinics) with terms of reference • Discuss models with others e.g. SWSCS • Establish terms of reference, letters of appointment, etc • Define who is part of the MDT for various tumours & stages of care

  7. DRAFT Polaris Action Plan (3) Define care co-ordination role & develop across tumour streams • June 04: examine other models • Look at other centres & what works • Find ways to fund the role • Select methods to evaluate the role with others e.g. Latrobe Uni • June 05: establish funding models

  8. DRAFT Eagle Action Plan (1) • June 04: Implement two Care Co-ordinators • Liaise with other Hospitals (Wellington, Alfred) • Write job descriptions • Obtain funding

  9. DRAFT Eagle Action Plan (2) Protocols/criteria (auditable) for patient selection onto treatment programs (also ceasing therapy) • June 04: Establish protocols • Meet with Oncology Unit to obtain agreement in principle; obtain evidence (EBM); develop protocols • June 05: Regular activity & peer review

  10. DRAFT Eagle Action Plan (3) • Review structure of “cancer services” to ensure integrated accountable service (service plan) • Work with hospital Executive to undertake Strategic Planning/Service Planning exercise • Review treatment protocols/care plans • Exist now but not updated for couple of years • Obtain funding to assist (med oncology time & ? Project officer)

  11. DRAFT Eagle Action Plan (4) • Consider alternative sources of funding – NGO • Discuss with Executive; obtain advice • Utilise data to review outcomes • Extend existing database; useful reports • Review what needed to utilise information – what wanted to achieve? • Resources – lack of med oncologists has been a problem

  12. DRAFT Eagle Action Plan (5) • June 04: Medical Care for febrile neutropenics) • Already in draft; need to progress • March 04: Involve PalliativeCare Specialists more in Integrated Team • Invite to MDT meetings • Review current cost-centre reporting to enable better delineation by expenditure • Improve drug information – separate haematology and oncology drug costs • Cost of stem cell transplants; number to be treated?

  13. DRAFT DionysisAction Plan • Dec 04: Clinical Cancer Stream with Director in control with strong degree of accountability and budget control • 7 day working in clinical area • Discuss with key players e.g. nurses • Continue to develop MDT within different cancer streams with co-ordinator for individual tumours • Require integrated data collection to track patients between institutions • Address isolation of services outside major centre by clinical cancer stream

  14. DRAFT Sirius Action Plan • Outpatient autologous BMT • Reduce radiation therapy waiting list • Process mapping • Review pressure points • Review roles • Use telemedicine for MDTs • Explore opportunity • Discuss with Director Cancer Services • MDT 2 sides • Core clinical • Core care

  15. DRAFT Jason/Athene Action Plan • Appoint Clinical Director (Jason/Athene) • Consolidate like services (Athene) • Develop Directory of Cancer Services (Jason/Athene)

  16. DRAFT Falcon Action Plan • Better document composition of MDTs & advertise them • Develop list of MDM members • Write procedures for MDMs • Advertise via website • Explore feasibility of outpatient BMT • Discuss with Haematology; develop guidelines; pilot program • Measure full range of patient contact activity • Review definitions of IP & OP episodes of service; modify data collection methods; provide the data

  17. DRAFT Fury Action Plan • Dec 04: Formalise Oncology as entity • Meet with service team reps (8 tumour groups) • Establish a business case • Appoint Cancer Care Co-ordinator to champion • Dec 04: Ensure MDMs occur across Cancer types • Identify where now occurring/not occurring • Local or central – video-conferencing • Composition of current MDMs • June 04: Ensure benefits of MDM realised or achieved • Policies, guidelines, protocols & audit • Review IT support required

  18. DRAFT Panther Action Plan (1) • June 04: Establish Exec Director Cancer Services for single point accountability • Progress and support within Hospital • June 05: broader approach • Develop Strategic Plan via Exec Director facilitation • Feedback and support this meeting’s discussion to Executive; planning day end year

  19. DRAFT Panther Action Plan (2) • June 04: Care Co-ordinator role • Decide tumour group; develop goals, roles etc; clarify opportunities for funding • 2005: evaluate role & extend other groups • Review MDM/Clinics/Teams • June 04: Develop terms of reference; engage stakeholders; establish review procedure

  20. DRAFT Panther Action Plan (3) • Emergency care access • June 04: work group report to MAG on issues & access for patients • feedback to MAG • formalise working group • identify areas for improvement • June 05: patient have good information regarding emergency access

  21. DRAFT Gemma Action Plan • June 04: complete business case for Integrated Cancer Service • Approval of CEO and Dept Health • Identify additional resources (business manager and secretary) • June 05: IC Service established • June 04: appoint dedicated data collector • Recruit assistance of IT staff

  22. DRAFT Electra Action Plan (1) • June 04: scope Website-based program • Review advantages as information base • Review existing examples • Study IT requirements & resources to maintain • June 04: review merits of Lantis program for institute data base • Observe in use at Liverpool; scope project & cost system; develop case for implementation if meets needs • Link to minimum data base sets (in development)

  23. DRAFT Electra Action Plan (2) • June 04: Information cards for patients • Reach concensus agreement to do • Design cards & issuing system • Tele-medicine • Define potential use to service and external stakeholders • Explore access to technology • Develop pilot program and trial

  24. DRAFT Thunder Action Plan (1) • Establish Breast Multi-disciplinary Clinic • Stronger ‘command and control’ structure • Review existing 7 clinics formal structures • Formalise membership and leadership • Ensure record of activity is kept • Extend Care C-ordination model to Chemotherapy giving process • Charge nurse buy-in • Develop written pathway

  25. DRAFT Thunder Action Plan (2) Tele-medicine • Peripheral clinic MDC and Palliative Care videophone in rural areas • Review current IT infrastructure • Review funding availability • Discuss with palliative care nurse

  26. DRAFT Thunder Action Plan (3) • Extend links between hospitals • continue HRT discussions and work with key HRT member hospitals • Support continuation of HRT model in other specialties • Write to CEO/medical director of hospital • Provide CEO with report

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