A cancer diagnosis and chemotherapy are stressful events, clear communication & education helps reassure and guide patients through complex pathways towards best outcome including prevention & appropriate management of treatment-related morbidities. CALD patients remain a priority cancer population in NSW, communication barriers may prevent access to educational support.
Improve the identification of CALD patients referred for chemotherapy & implement targeted education/communication support.
Multidisciplinary project team reviewed existing processes for educating CALD patients referred for chemotherapy, clinical staff surveyed on satisfaction with CALD communication. Gaps/variations were explored for cause/effects. Consensus, weighted multi-voting prioritised the following strategies for Plan-Do-Study-Act approach; CALD patient identification, scheduling/use of interpreters & multilingual communication/education resources.
An interfaced data field was introduced to identify CALD patients with a non-English preferred language, leading to a 81% improvement in scheduling education via interpreter pre-cycle 1 chemotherapy. Inservices on multicultural awareness and health-interpreter services were organised to assist staff. Development of a standardised process has streamlined interpreter use; cancellation related to mistimed scheduling dropped from 19% to 1.5% & use of telephone-interpreter-services increased. A flip-chart tool was developed to assist pharmacists communicate with patients at subsequent cycles of chemotherapy. e.g. monitoring common side-effects and optimising medication supportive care. The flip-chart has been translated into 10 languages common in Western Sydney& has been validated for comprehension and clarity.
Process review, audit & survey verified deficiencies in identification & education of CALD cancer patients. There had been inconsistent & inefficient use of health interpreters (reliance on family/bilingual staff & scheduling of interpreters poorly coordinated to staff & patient availability). Local demographics necessitated improvements in targeted communication with CALD patients during chemotherapy. Strategies implemented assist pharmacists to educate patients, assess & manage side-effect and monitor compliance. These interventions help support & guide CALD cancer patients through treatment.