Background
Optimal Care Pathways (OCPs) are national guides developed by clinical experts that describe the best possible cancer care for patients. Each OCP describes seven key steps in a patient’s cancer journey, from health promotion to survivorship or end-of-life care, and the expected care at each stage.
Implementation science is focused on translating evidence into practice. In Victoria, a statewide strategy has been applied to facilitate a primary care adoption and implementation of the OCPs using implementation science principles (Braithwaite 2018).
Six Primary Health Networks (PHNs) are working together to facilitate the adoption of the prostate and oesophagogastric cancer OCP through building general practitioner (GP) awareness, knowledge and use of the OCPs and resolving areas for local service improvement to facilitate optimal cancer care.
Methods
Evidence-informed strategies for facilitating implementation were applied to statewide and local efforts. Key efforts include i) development of localised online care and referral pathways (referred to as HealthPathways) for use at point of care, ii) GP engagement and clinical networking with specialists, iii) active primary care communication and engagement strategies, and iv) PHN catchment-specific programs of work.
Results
Sector feedback has shown increased awareness and use of OCPs. The tiered implementation approach which blended statewide macro efforts with clinically driven programs of work has resulted in extensive workforce engagement (n=1,107), GP and practice nurse skills development, and organisational adoption readiness. Access to evidence based clinical content and information on referral options can facilitate navigation and flow. Local programs of work have provided a basis for progressing clinically identified priorities for health service improvement.
Conclusions
OCPs are a framework that provides clarity on role delineation for better practice across the cancer journey. A robust multi-pronged implementation approach which is informed by implementation science principles offers a novel approach to an often-missed aspect of guideline development.