Currently, clinical governance structures vary between public Hospital and Health Services (HHS) throughout Queensland. Consistent frameworks do not exist to govern the clinical actions of medical, pharmacy, nursing and other staff for the delivery of chemotherapy treatments in the cancer context. Other sub-specialties in cancer are governed by professional body-level frameworks, ensuring minimum standards for high-quality, safe and patient-centred cancer care.
A statewide, whole-of-system standards and governance framework was identified as a need for cancer chemotherapy in Queensland. An opportunity to align public cancer chemotherapy services with appropriate minimum standards in safety, quality and governance practices that ensures optimal care is delivered to cancer patients was subsequently pursued.
An innovative, multidisciplinary and clinician-led approach was developed to facilitate engagement across public cancer services that have distinct variations in service capability, rurality and maturity. High-quality interactions with clinicians throughout Queensland were initiated by establishing a tripartite steering committee consisting of representatives from medicine, nursing and pharmacy, from both metropolitan and regional facilities. Utilisation of videoconferencing technologies promoted additional regional clinician participation in the iterative design and feedback process of this framework. This consultation structure supported bi-directional communication between and within HHS and professional disciplines, further supporting stakeholder engagement in the development of a statewide framework. The primary challenge ahead is maintaining sustainable engagement with the vast number of stakeholders involved, beyond the initial consultation phase. This work is ongoing.
The expected outcome of the standards and governance framework under development is to facilitate clinical governance statewide to ensure quality assurance at the system, clinician and patient levels, and enable chemotherapy treatments to be measured against key reporting indicators. This process will allow for dynamic improvements to cancer chemotherapy provision across Queensland, and support the agility required to incorporate emerging treatments as they arise.