Treatment Standards Development –A work in progress

Aims:

The aim of this work is to develop Treatment Standards at the Andrew Love Cancer Centre (ALCC), by establishing a systemic evidence based review platform for each tumour stream to ensure they are consistent with evidence, complete and efficient.

Methods:

With the advent of electronic chemotherapy prescribing at ALCC, came the responsibility to ensure that these treatments were kept current. Once the treatment pathways had been embedded into clinical practice, it was decided that an evidence based review of the treatments be implemented. During the first year, each tumour stream was reviewed, by the lead and second medical oncologist, using eviQ (Cancer Institute New South Wales) and the NCCN (National Comprehensive Cancer Network, USA) as standard references. The electronic prescribing system was updated to reflect this review.

Through a continual improvement process radiation treatments were incorporated into the review to ensure a complete Treatment Standard was available for each tumour stream. The committee expanded to include the lead and second radiation oncologists for each tumour stream.  Draft standards, were discussed, circulated, updated and verified by the committee members.

Results:

Each oncology tumour stream has evidence based treatments available, set out in libraries specific for each diagnostic stage of the disease.  These verified standards of treatment are kept electronically, and are accessible to all ALCC staff to aid in making clinical decisions at the patient level.  They are flexible to provide individualized treatment at the patient level, while remaining evidence based for further selection.

Conclusions:

Meetings are held monthly, with each tumour stream discussed annually. The next steps in the continuum of review will be to audit how the standards have been used during the previous year, develop procedures for inclusion of new treatments, and develop a more sophisticated decision tree.