Simplifying complexity: Cancer Pharmacy Services for Chemotherapy Units in Rural South Australia — ASN Events
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Simplifying complexity: Cancer Pharmacy Services for Chemotherapy Units in Rural South Australia (#323)

Belinda Morris 1 , Kate Dreyer 2
  1. Country Health SA LHN, Adelaide, SA, Australia
  2. SA Pharmacy, Adelaide, South Australia

Background
In 2011 the State-wide Cancer Control Plan1 was released, which advocated improved cancer services for patients living in rural South Australia (SA).
In 2012 a Cancer Pharmacy Services Model was developed to guide the delivery of pharmacy services to existing and newly established chemotherapy units across country SA in accordance with best practice guidelines2,3,4 and the patient pathways articulated in the plan.
Aim
To translate the Model into improved clinical practice across Country Cancer Services and Chemotherapy Units by simplifying pathways using minimal extra resources.
Methods
A gap analysis was conducted to examine current service provision relative to the Model and identify priority areas for review. A phased implementation of pharmacy services was planned in-line with the opening of the new units.
Results
The gap analysis revealed complex chemotherapy service pathways at some existing units resulting from inconsistent resource allocation and identified several priority areas for development including:
• Education and training
• Communication
• Procedural and clinical guidance to support consistent supply processes between pharmacy departments
• A state-wide approach to cold-chain maintenance and transport

Measures have been implemented to ensure quality improvement in these areas. To date, six new units have opened and chemotherapy has been delivered in accordance with best-practice and in a timely manner. Challenges encountered during implementation include; pharmacist access to patient information and clinic bookings, inconsistent courier paperwork requirements and receipt of chemotherapy at units.
Documenting and reviewing these challenges is enabling the project team to anticipate and avoid similar issues at subsequent sites.
Discussion
A state-wide approach to service development has helped simplify complex service pathways, standardise clinical processes and save duplication of work.
A phased implementation approach has ensured effective delivery of chemotherapy to patients in rural centres without additional resources and facilitated a planned approach to quality improvement at existing units.

  1. SA Health. Statewide Cancer Control Plan 2011-2015. Adelaide: Government of South Australia; 2011.
  2. Carrington C, Stone L, Koczwara B, Searle C, Siderov J, Stevenson B, Michael M, Hyde S, Booth A, Rushton S. (2010). The Clinical Oncological Society of Australia (COSA) guidelines for the safe prescribing, dispensing and administration of cancer chemotherapy. Asia-Pacific Journal of Clinical Oncology 2010; 6: 220-237.
  3. The Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Oncology. SHPA Standards of Practice for the Provision of Clinical Oncology Pharmacy Services. J Pharm Pract Res 2002; 32(2): 115-118.
  4. The Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Cancer Services. SHPA Standards of Practice for the Provision of Oral Chemotherapy for the Treatment of Cancer. J Pharm Pract Res 2007; 37(2): 149-52.