Patient-centred quality cancer care


The NSW Cancer Plan focuses on delivering quality cancer care that is driven by patient needs.

By enabling people to give feedback about their cancer experience, we learn more about their priorities and concerns. This helps us improve our health system and provide more personalised care to people affected by cancer.

Building a patient-centred quality cancer system

Professor David Currow

 

What we are achieving in patient-centred quality cancer care

The Cancer Institute NSW continues to work across the cancer system to improve patient outcomes. Here's how we have made a difference over the past 12 months.

Collecting and using patient feedback

We are committed to putting people with cancer at the centre of their care. Patient-reported measures are a key way that people can provide feedback about their cancer experience and overall wellbeing.

Types of patient feedback include:

  • Patient reported experience measures, known as PREMs
  • Patient reported outcome measures, known as PROMs.

Patient-reported experience measures (PREMs)

Each year, we work with the Bureau of Health Information to report on the experiences of people with cancer through the Outpatient Cancer Clinics Survey.

The survey responses are used to:

  • track progress on key aspects of care, such as involvement in decision making and effective communication
  • understand how patients rate their overall care
  • inform new initiatives to support people with cancer to better understand and play an active part in their treatment and care
  • support local health districts (LHDs) and participating private hospitals to identify how they can improve local cancer services and patient care.

For example, the survey asks patients if they smoke, and if this was discussed during their clinic visit. A person's response to these questions can show if smokers who visit the clinic are being supported to quit. This is important because quitting smoking can improve cancer outcomes, and continued smoking by people with cancer can affect survival.1,2

Patient-reported outcome measures (PROMs)

PROMs surveys record a patient’s views on how cancer and treatment have affected their overall wellbeing. They also help to identify issues and concerns that are important to patients.

Two statewide Advisory Groups led the design and development of a survey system which allows cancer services to:

  • capture PROMs survey feedback on an electronic device  
  • review survey results in the patient’s electronic medical record
  • provide patients with tailored information about areas of concern raised in their survey responses. This information is taken from the Cancer Institute NSW patient information resource.

We are working to expand the use of the PROMs system, which is already live at a number of cancer services in NSW. 

We are also engaging with our consumers and multicultural and Aboriginal working groups to develop in-language and culturally-safe PROMs surveys. Following a successful pilot of an in-language survey for Arabic-speaking patients at Bankstown-Lidcombe Hospital, surveys are now being developed in eight languages and will be made available for cancer centres using the PROMs system.

Read more about the key studies informing this project, and how patient-reported measures are captured.

Supporting people with cancer to find information and be involved in their care

T.I.P.S.

tips-1.png

In 2017, we introduced the T.I.P.S. guide to help people take control of their cancer care.

The guide has been designed to help patients with cancer know where to access information and to have a conversation with their doctor. T.I.P.S. covers four aspects of care that can improve patient experience:

  • Team: Have care overseen by a multidisciplinary cancer care team.
  • Involvement: Be informed and get involved in decisions.
  • Plan: Know the next step in treatment and who to contact.
  • Support: Know the people and support services available.

The T.I.P.S. guide is now available in four languages: Arabic, Simplified Chinese, Traditional Chinese and Vietnamese. People can read, listen or watch videos in these languages.

Patient information

patinfo.pngOur patient information resource is designed to help users find trusted, reliable information about cancer. The website currently has information on 33 different cancer types.

The content aligns with national optimal cancer care pathways, and helps users understand key steps in the care pathway and the importance of multidisciplinary care.

Features include:

  • a basic introduction to each topic
  • links to more detailed information from reliable sources
  • checklists of tips or questions to ask
  • the ability to save and print pages, links and checklists
  • a focus on Australian information, supplemented with relevant international links.

This resource supports our patient-reported measures program, with patients having the option to receive tailored information from the website based on their survey responses.

There also is content to address the information needs of priority groups identified in the NSW Cancer Plan, including:

  • an Aboriginal and Torres Strait Islander page with links to a range of culturally-appropriate resources
  • a multicultural page, now translated into eight community languages (Arabic, Simplified Chinese, Traditional Chinese, Greek, Italian, Korean, Spanish and Vietnamese), with links to further in-language resources from other organisations.

Additional in-language pages are being added to provide supportive information for patients completing in-language PROMs surveys.

NSW Cancer Plan initiatives for a patient-centred quality cancer care system

The NSW Cancer Plan focuses on patient-centred quality care, from prevention to diagnosis, treatment and survivorship.

While all of the Plan’s activities contribute to this, a number of strategies are particularly important:

  • smoking cessation programs, guided by the NSW Smoking Cessation Framework, are available and offered to all cancer patients who smoke
  • cancer screening is integrated into the provision of primary care
  • all people with suspected cancer have timely access to assessment and diagnostic services, and have their care overseen by a multidisciplinary team
  • diagnostic pathways are defined and measured with benchmark reporting and health system feedback
  • patient assessment and management is supported by an integrated information system, ensuring all involved in the process of care can access essential information at the point of care
  • cancer clinical trials are made available to patients and are integrated into service delivery
  • palliative care and supportive care services are integrated into the delivery of cancer services
  • people with cancer are supported to access and understand information relevant to their cancer treatment and self-management
  • patient-reported measures contribute to system improvement
  • a virtuous cycle of analysis, feedback, response and re-measuring supports improvements in the delivery of cancer services and outcomes for people affected by cancer.

Progress of the NSW Cancer Plan is regularly monitored and evaluated. Find more information using our NSW Cancer Plan Performance Index.

References

1. Warren GW, Sobus S, Gritz ER. The biological and clinical effects of smoking by patients with cancer and strategies to implement evidence-based tobacco cessation support. Lancet Oncol. 2014;15:e568–80. doi: 10.1016/S1470–2045(14)70266–9.

2. United States, Department of Health and Human Services . The Health Consequences of Smoking– 50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.