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Oceanic Palliative Care Conference 2023
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Care Plus implementation strategies to early palliative care in haematology cancer services

Oral Presentation Concurrent Sessions

Oral Presentation - Concurrent Sessions

2:45 pm

13 September 2023

Exhibition Hall Theatre - Level 2

Stream 2B | Concurrent Session | Health System Reform

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Presentation Description

Institution: The University of Melbourne & St Vincent's Hospital Melbourne - Victoria, Australia

Background Early palliative care (PC) has been shown to improve outcomes for patients with advanced haematological cancer including Multiple Myeloma (MM). ‘Care Plus’ is a stepped wedge implementation trial testing usual care (control) versus early PC integration as practice change across cancer services at four Australian metropolitan tertiary public hospitals.  
Aims To describe the utility of the Care Plus pathway implementation strategies in integrating PC with haematology oncology services including MM. 
Methods This qualitative research study design was introduced at a standardised point(s) in the illness, either at the time of diagnosis or first relapse of MM. Semi-structured interviews with participants were conducted via Zoom or face-to-face during pre-practice, practice and post-practice change to explore the implementation strategies. Interview transcripts were thematically analysed by making codes with emerging themes via NVivo. Member-checking was utilised for maintaining rigour and validity. 
Results Care Plus team conducted 20 interviews with haematologists (n=4), PC physicians (n=9), clinical nurses (n=3), MM patients (n=4), and MM nurse care coordinators (n=4). Major themes for strategies included: benefits of automatic standardised points for referral to early PC as a system wide change, development of language as ‘Care Plus’ plus scripts for introducing early PC by health personnel to patients and carers, PC presence in multidisciplinary meetings, enhanced collaborative practice between haematology and PC teams, and the value of exploring future goals and planning with early PC including asymptomatic patients. 
Conclusions Care Plus implementation strategies provided a systemic approach to integrating PC with MM oncology services. For haematology clinicians, the Care Plus model appeared to provide an opportunity to ‘re-imagine’ how PC may be delivered and the role it plays in patient care.  

Presenters

Authors

Authors

Professor Anna Nowak - The University of Western Australia , Professor Meinir Krishnasamy - The University of Melbourne , Doctor Tanara Vieira Sousa - The University of Melbourne , Associate Professor Nicole Rankin - The University of Melbourne , Ms Lorna Gurren - Dublin City University , Professor Gregory Crawford - The University of Adelaide , Doctor Farwa Rizvi - The University of Melbourne and St Vincent's Hospital Melbourne , Professor Jennifer Philip - The University of Melbourne & St Vincent's Hospital Melbourne , Professor Brian Le - The University of Melbourne, Peter MacCallum Cancer Centre & The Royal Melbourne Hospital , Emeritus Professor Geoff Mitchell - The University of Queensland , Associate Professor Sue-Anne McLachlan - The University of Melbourne & St Vincent's Hospital Melbourne , Ms Kylee Bellingham - The University of Melbourne and St Vincent's Hospital Melbourne , Ms Joyce Chua - The University of Melbourne & St. Vincent's Hospital Melbourne , Ms Robyn Hudson - Safer Care Victoria , Professor Maarten IJzerman - The University of Melbourne , Doctor Anna Collins - The University of Melbourne & St Vincent's Hospital Melbourne , Associate Professor Vijaya Sundararajan - The University of Melbourne & St Vincent's Hospital Melbourne

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