Development of a capability framework to support the provision of chemotherapy within a shared care model for children and adolescents with cancer — ASN Events
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Development of a capability framework to support the provision of chemotherapy within a shared care model for children and adolescents with cancer (#239)

Jane Williamson 1 , Chris Williams 1 , Peter Downie 1 , Craig Underhill 2 , Catherine O'Connell 3 , Zane Healy 3 , Sam Peet 3 , Jenny Commins 3 , Kathy Vickers 4 , Chris Packer 2 , Rebecca Myers 2 , Francoise Mechinaud 5
  1. Paediatric Integrated Cancer Service, Melbourne, VIC, Australia
  2. Hume RICS, Wodonga, VIC, Australia
  3. Albury Wodonga Health, Albury, NSW, Australia
  4. Murrumbidgee Local Health District, Albury , NSW, Australia
  5. Royal Children’s Hospital, Melbourne

Aim
To extend the model of formalized shared care between the Royal Children’s Hospital (RCH) and Albury Wodonga Health (AWH) using an evidence-based framework for low complexity chemotherapy for children and adolescents appropriate for shared care.

Methods
The Regional Outreach and Shared Care Program (ROSCP) is an initiative of the Paediatric Integrated Cancer Service (PICS) that aims to implement agreed levels of training and standards of care in regional centres caring for children and adolescents with cancer. A program review identified an opportunity to develop a framework for the provision of low complexity paediatric chemotherapy and AWH was selected as the pilot site for implementation of the model.

Results
Partnerships were established between RCH, PICS, AWH and HumeRICS to develop an evidence-based framework comprising recommended standards for infrastructure, workforce, communication and training required to competently and safely implement a paediatric chemotherapy service. Protocols have been established for the delivery of chemotherapy by trained AWH paediatric staff, with mentoring provided by adult oncology unit staff. This initiative is limited to the delivery of Vinchristine via a Central Venous Access Device to children with leukaemia receiving maintenance chemotherapy, which will equal approximately one dose of chemotherapy at AWH each fortnight. Two outpatient chemotherapy chairs have been commissioned in the paediatric unit and the service is anticipated to commence in the third quarter of 2013.

Conclusions
A detailed service capability framework has been developed to support the provision of a regional paediatric chemotherapy service as part of the formal ROSCP, and a partnership between the AWH paediatric staff and adult oncology unit staff has been established. This best-practice service will be available close to the patient’s home, substantially reducing travel costs and impact of cancer on family life in the future. The model is currently being evaluated and further data will be presented.