Implementation of a decision support triage tool in specialist-general practitioner shared care

Project Status
Current

Chief Investigator
Kerry Uebel (SPHCM)

Project Coordinator
Maria Agoliotis Kylie Vuong (SPHCM), Stella Jun (TCRN)

Team Members
Jane Taggart, Mark Harris, Winston Liauw (St George Hospital) John Lewis (Consumer) Kate Webber (TCRN)

Project Rationale

Advances in treatment have increased the chance of an individual diagnosed with cancer surviving for 5 years or more. Colorectal cancer is the most common cancer diagnosed in males and females. Colorectal cancer survivors make up the third largest group among males and the second largest group within females.

The conventional model for follow-up care after colorectal cancer sees patients attending for periodic review 3-6 monthly in tertiary cancer services. With growing numbers of cancer survivors, this approach is not sustainable, and data suggests that Australian survivor numbers will imminently outgrow the oncology workforce.

Project Aim/s

  1. To identify patient scenarios at ‘low-intermediate risk’ of complications that are suitable for shared care based on a decision support triage tool
  2. To assess perspectives from cancer specialists, GPs and people who have experienced colorectal cancer on the suitability of the ‘low-intermediate risk’ patient scenarios and resources needed to support the shared care team model.

Project Design and Method

A decision support triage tool has been developed to identify scenarios at ‘low-intermediate’ risk of complications and therefore suitable for shared care.

The tool is based on known patient criteria that are associated with better long-term outcomes:

  • No oxaliplatin chemotherapy during colorectal cancer treatment
  • No bowel incontinence since colorectal cancer treatment
  • No stoma or other permanent effect from cancer surgery.

Step 1:  Development of patient scenarios at ‘low-intermediate risk’ of complications for shared care based on currently available tool (Decision support Triage Tool)

The scenarios will represent the full spectrum of colorectal cancer patients ranging from ‘low-intermediate risk’ to ‘high risk’. The ‘low-intermediate risk’ scenario will also be guided by the decision support triage tool.

Step 2:  Recruit and interview cancer specialists, GPs and people who have experienced colorectal cancer about the patient scenarios and assess their perspectives on the suitability of these patients for shared care.

A qualitative multi-method design that combines questionnaires with semi-structured interview.  Participants will include:

  • 6-8 Cancer specialists
  • 6-8 GPs
  • 10-14 Patients

Step 3:  update the Decision Support Triage Tool and determine who’s suitable for share care

Publications

Nil yet