Aim:
The ovarian cancer Optimal Care Pathway (OCP) sets out principles for best practice, evidence based care along the patient pathway. The Department of Health and Human Services Victoria funded a state wide project to understand and assess current practice and identify gaps against the OCP.
Method:
Retrospective data analysis was undertaken using cancer registry, hospital admission and multidisciplinary meeting (MDM) data sets. Measures included location and timeliness of treatments, proportion that had treatment planning by MDM and quality of MDM. Consumer and clinician interviews were undertaken.
A state wide steering committee made up of expert gynaecological oncologists, consumers, non-government organisation and Primary Health Network representatives and service improvement specialists was established to review the data analysis.
Results:
More than 80% of newly diagnosed public and private patients had surgery at a hospital with specialist gynaecological oncologists. 92% women treated in the public sector had MDM treatment planning. Timeliness to adjuvant chemotherapy had a median of 31 days compared to the OCP within 28 days surgery.
High and low volume metropolitan hospitals and regional cancer centres all provided supportive care screening. Assessment of MDM quality demonstrated appropriate membership and communication to GPs / referring doctors. Regional cancer centres had links with specialist centres via MDMs and outreach services. Qualitative interviews identified key improvement areas, including strengthening referral pathways for specialist care and a call for the establishment of a service capability framework with role designation.
Gaps in data availability meant that components of the OCP could not be assessed, including advance care planning.
Conclusion:
This review of ovarian cancer care against the OCP showed high levels of alignment in the acute services. Opportunities for improvement were identified with a focus on inter-organisation strengthening. A call for the establishment of a service capability framework with role designation was a clear message.