Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2017

Implementing Pathways for Cancer Early Detection (I-PACED): Identifying systems level issues in primary care (#15)

Amber Kelaart 1 , Jeanne Potts 1 , Robyn Tucker 1 , Katherine Lane 1 , Amanda Vittiglia 1 , Jon Emery 2 , Marita Reed 3 , Natalie Appleby 2 , Anna Boltong 1 2
  1. Cancer Council Victoria, Melbourne, VIC, Australia
  2. The University of Melbourne , Melbourne, VIC, Australia
  3. The Department of Health and Human Service, VIC, Australia


The Optimal Care Pathways (OCPs) have been developed to facilitate consistent, safe, high quality, evidence-based cancer care across Australia. Implementing PAthways for Cancer Early Diagnosis (I-PACED) is a collaborative project between Cancer Council Victoria (CCV) and The University of Melbourne which promotes best practice cancer care and the adoption of the OCP recommendations into primary care. The project utilises an educational outreach model, with visits facilitated by CCV nurses into GP practices.


To explore issues experienced by GPs and practice staff in implementing care recommendations contained in the lung and colorectal OCPs


A database of issues was established to capture CCV nurses professional reflections at the conclusion of practice education visits. Themes of focus included identified barriers, improvements and information requests that impact on the implementation of the OCP recommendations. Issues were categorised using National Health Performance Framework for health systems domains: Effectiveness, continuity of care, safety, accessibility, responsiveness and efficiency & sustainability. Data was collected and reported at a practice level. 


Reflections from 156 GP practice visits established that reported issues related mostly to the domain of accessibility. This included lack of timely access and transparency of waiting lists for procedures and treatments (57% of practices), financial implications and transparency of costs to patients (38%) and current resources not meeting the needs of CALD populations (14%). Issues impeding the effectiveness of care provision included suboptimal GP awareness of screening programs (18%) and patient compliance factors (16%). GP’s most commonly identified the implementation of standard referral forms and processes as a key improvement to enhance efficiency & sustainability (24%).


Findings will be used to advocate for systems level improvements to support implementation of optimal cancer care in the primary care setting. Themes generated from this study can be extrapolated to other cancer tumour streams.