The Victorian Lung Cancer Service Redesign Program (VLCSRP) was established in 2016 to support development of local redesign projects to decrease delays in the diagnosis and treatment of lung cancer. Five pilot projects were completed in health services across Victoria. This paper identifies the transferable learnings that emerged from this program of work.
Service redesign methodologies were used to understand performance and improve processes. The Victorian Lung Cancer Registry (VLCR) was engaged to ensure a standard approach to data collection and project evaluation. Both quantitative and qualitative data was collected. Four Community of Practice forums were held to support collaborative learning.
A number of lessons emerged from this pilot. Future participation in local projects should be contemplated in the setting of anticipated organisational changes. Prior to project commencement, the governance, confidentiality and insurance requirements for each service provider / privately practicing clinician need to be identified. Future grant recipients may benefit from a Memorandum of Understanding between parties with defined clauses. More robust planning around data collection including longer lead in time for ethics approval and introduction of clinical registries is recommended. Use of standardised questionnaires for interviews is more likely to produce a more robust data set for inter-project comparison. The availability, capability and resources available to service redesign teams is site specific and may not be presumed to be equivalent. Solutions frequently require a business case to progress, which may fall outside of project timelines and local budget cycles, potentially delaying delivery of the complete solution. A detailed cost analysis of future programs of work against outcomes and investment should be considered by relevant governing bodies.
This study highlighted a number important learnings that will inform the development of future initiatives seeking to progress the timeliness of care across lung and other tumour streams.