Integrated Cancer Services Plan HNHB LHIN

Transcription

1 Integrated Cancer Services Plan HNHB LHIN Dr. Bill Evans, Regional Vice-President, CCO Carol Rand, Director, Systemic, Supportive, Regional Cancer Programs

2 Organizational Structures for Regional Cancer Services Hospital Administration President & CEO HHS M. Martin Regional Cancer Program Governance & Committee Structure Cancer Administration CEO, Cancer Care Ontario M. Sherar Executive V. P. Clinical Operations B. Flaherty Vice President, Regional Cancer Programs Judy Burns President JHCC Regional Vice President, B. Evans Director, Regional Cancer Program Carol Rand Regional Cancer Program Priorities & Planning Committee * Development of Disease Site Specific Cancer Committees Hospital Cancer Councils Regional Programs and Networks Systemic, Radiation, Surgical Oncology, Integrated Cancer Screening, Palliative Care, Aboriginal, Primary Care, Patient Education, Diagnostic Imaging, Pathology * Membership includes Designated Cancer Leads from each hospital in the LHIN

3 Development of the Integrated Services Plan (ICSP) guided by: Hamilton Niagara Haldimand Brant LHIN Vision o A health care system that helps keep people healthy, gets them good care when they are sick, and will be there for our children and grandchildren. Cancer Care Ontario Vision and Mission o o Working together to create the best cancer system in the world. We will improve the performance of the cancer system by driving quality, accountability and innovation in all cancer-related services HNHB Regional Cancer Program Vision o Equal access to coordinated system of high quality cancer services across the continuum of care, from prevention and early detection through to palliative care, across the region

4 Development of the ICSP Leadership from: Regional Vice-President Deputy RVP Regional Cancer Program Director Regional Planning and Priorities Committee Medical Discipline Heads and Network Leaders Directors of Cancer Programs and Networks

5 RCP Priorities and Planning Committee Purpose: The Regional Cancer Program (RCP) Priorities & Planning Committee will provide strategic oversight and direction for the development and implementation of all cancer services, as defined through a Memorandum of Agreement (MFA), across HNHB LHIN. The membership is committed to the development of a strong and innovative RCP in the LHIN. Objectives: 1. To support the RCP RVP to lead cancer services planning within the LHIN as part of the province-wide cancer planning. 2. To identify strategies to meet regional needs for service, integration, co-ordination and quality improvement. 3. To facilitate patient and consumer involvement in planning and evaluating activities. 4. To implement provincial standards and report on the LHIN s performance relative to these standards. 5. To monitor and report on the LHINs programs and services. 6. To respond to performance results for the LHIN, which may require assessment and re-alignment of where and how services are provided.

6 Development of Cancer Priorities for ICSP Cancer Incidence and Prevalence Data by Disease Site within the LHIN Regional Modifiable Risk Factor Profile Understanding of Current Capacity Issues and Challenges Direction of Ontario Cancer Plan (2005, 2008, 2011) Regional Priorities Established in Consultation with CCO and in Alignment with OCP Cancer System Quality Index Data

7 Development of Cancer Priorities for ICSP o RCPPC Review of Data, OCP III, Challenges, Opportunities o Alignment with LHIN Clinical Services Plan o Agreement on Regional Priorities o Agreement on Template & Domains o MRPs for each Priority o Interactive Process o Milestones established over 4 years of the plan

8 Key Strategic Priorities 1. Development of the Walker Family Cancer Centre as an integrated partnership with JCC 2. Implementation of common Oncology-specific Information System across HNHB LHIN 3. Strengthen and Integrate Regional Programs 1. Radiation Therapy 2. Systemic Therapy 3. Cancer Surgery Consolidate complex cancer surgery (Gyne, HPB, Thoracic, Sarcoma) 4. Palliative care 5. Integrated Screening Program 4. Strengthen Regional Networks

9 Strategic Priority 1 Development of Cancer Program at Walker Family Cancer Centre MOU to create an integrated partnership Establish medical and administrative leadership Establish Clinical Department of Oncology at NHS Build one radiation oncology program on 2 sites Expand screening services, systemic therapy Develop supportive and palliative care services Develop disease site subspecialization amongst oncologists, MCCs Implement common cancer information systems

10 Strategic Priority 2 Implement Regional Cancer Informatics Strategy Regional cancer informatics plan developed Director, Integrated Cancer Informatics recruited Agreement on common oncology-specific information system obtained Implement Meditech registration/adt interface to OPIS 2005, MOSAIQ Focus on integration of JCC/HHS and WFCC/NHS but strategy to be extended to JBMH and BCHS Utilize Clinical Connect to link oncology specific information across system Utilize the Dir to facilitate access to cancer images

11 Strategic Priority 3: Strengthen and Integrate Regional Cancer Programs Radiation Therapy Program Develop integrated administration and HR for single program model Increase regional radiation therapy utilization: radiation oncologists in more community-based clinics, Engage radiation oncologists in more community-based multidisciplinary case conferences (MCCs) Systemic Therapy Program: Implement Regional Systemic Therapy Plan Establish a Regional Systemic Therapy Committee; enhance regional MO resources (AFP positions) to bring systemic therapy closer to home where possible (Brantford, St Catharines)

12 Model for the Full Integration of Systemic & Radiation Therapy Services Through the JCC, Walker Family Cancer Centre, Brantford General Hospital and Joseph Brant Memorial Hospital Affiliate Clinics* Juravinski Cancer Centre Level 1 Facility Education & Research (Clinical Trials) Systemic Therapy (complex, tertiary cases) Radiation Therapy Treatment Brachytherapy IMRT Cyberknife Brantford General Hospital Satellite Level 3 Facility Evolving to DST model Increase Systemic Therapy clinics to 5 days per week Increase Radiation Oncology Follow up Clinics Regional Systemic & Radiation Therapy Program Joseph Brant Memorial Hospital Satellite Level 3 Facility Evolving to DST Systemic Therapy Radiation Oncology Follow up Clinics Haldimand Norfolk Referrals to Brantford General Hospital & JCC Community Oncology Clinic as appropriate for Systemic Therapy Welland Affiliate Systemic Therapy Follow-up Clinics Walker Family Cancer Centre Level 2 Facility (2013) Education and Research (Clinical Trials) Systemic Therapy Radiation Therapy Treatment Niagara Falls Affiliate Systemic Therapy Follow-up Clinics *Includes the implementation of the Disease Site Team (DST) Model across the LHIN, multidisciplinary case conferencing, plus a regional cancer informatics system to support care across the continuum. Definitions of Level 1, 2, 3 according to CCO definitions for Level of Care.

13 Strategic Priority 3: Surgical Oncology: Regional cancer surgery lead and representatives of 6 hospitals doing the majority of cancer surgery make up SON Enhance the interaction between surgeons doing cancer surgery across the LHIN Implement provincial guideline and standards developed through CCO Consolidate tertiary activity; disperse common cancer surgeries predominately to community Local surgical leads to encourage colleagues to engage in MCCs and other quality initiatives Quarterly review of performance/quality metrics Regional Workshops: breast, colorectal, prostate

14 Strategic Priority 3: Consolidation of Complex Surgical Oncology Implementation of CCO Standards for high complexity surgery: o Thoracic Consolidated to St. Joseph s Hospital; NHS and JBMH have both agreed to stop thoracic oncology Lung DAP established at St. Joe s and St. Catharines General o Hepatobiliary HPB from MUMC and St. Joe s consolidated to Juravinski Hospital as part of HHS Access to Best Care

15 Model for the Delivery of Cancer Surgery* Brantford General Hospital Joseph Brant Memorial Hospital Norfolk General Hospital Hamilton Health Sciences Gyne-Juravinski CNS-General HPB Juravinski Sarcoma St. Catharines General Hospital West Haldimand General Hospital HPB Regional Cancer Surgery Model Niagara Health System Greater Niagara General Hospital Haldimand War Memorial Hospital West Lincoln Memorial Hospital St. Joseph s Hospital Thoracic Prostate Head & Neck Endocrine Sarcoma Ophthalmology Thoracic Welland General Hospital * Consolidation of specific sites to HHS and St. Joseph s Hospital, with general surgery for breast, colorectal and GU delivered across the LHIN at all hospitals

16 Strategic Priority 3: Palliative Care Develop a regional palliative care network Implement 9 CCO recommendations within region Establish a TAPCU at JHCC Implement standard symptom management assessment tools (ESAS) across LHIN Collaborate with HNHB Hospice Palliative Care Network to increase use of standardized assessment tools across LHIN (ESAS, PPS)

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18 Strategic Priority 3: Integrate Cancer Screening Programs Participate in CCO plan to integrate breast, cervix and colon cancer screening programs Implement recruitment strategies using geospatial mapping support to recruit underserviced populations Focus on quality improvement in CCC (reduce rejected kits, evaluate FIT) and efforts to engage family physicians Convert hospital and IHFs to OBSP centres Expand cancer genetics program at JCC

19 Strategic Priority 4: Implement Regional Networks Prevention Network Build support for implementation of the Ottawa Smoking Cessation Program in all regional hospitals Collaborate with partners in regional prevention network on educational initiatives on cancer risk factors obesity, smoking, exercise, alcohol, consumption Primary Care Network Collaborate in development of integrated cancer screening program Develop electronic tool to aid primary care physicians diagnose and refer patients with suspicion of cancer

20 Strategic Priority 4 Pathology Network Through regional network, implement synoptic reporting across all hospitals and all tumour types Develop SOPs for specimen handling, molecular markers Undertake teaching workshops (Gyne oncology pathology focus: fall 2010)

21 Strategic Priority 4 Cancer Imaging Network (new) Conduct environmental scan; develop regional action plan Knowledge transfer, stakeholder education re: standardizing access to high quality oncology interventions Implement guidelines on role of breast MRI in screening and preop staging; optimization of radiological assessment of patients with rectal cancer Work with CCO on provincial guidelines for vascular access and image guided biopsies

22 Strategic Priority 4 Psychosocial Oncology Establish a regional psychosocial oncology network with reps from cancer clinics, CCAC, CCS, Wellwood and WellSpring Niagara Undertake environmental scan of resources; post resources online Cancer Education Standardize regional cancer patient education materials Improve linkages to other cancer information providers (shared library processes with Wellwood; website link to community resources in collaboration with Canadian Cancer Society Conduct 3 patient forums per year in collaboration with disease sites (e.g. Lymphoma Conference, Kidney Conference)

23 Alignment with Clinical Services Plan Community based care closer to home; enhanced primary care engagement (diagnosis, referral, follow-up) Collaboration between institutions and professionals and enhanced inter-professional engagement Consolidation of complex care to tertiary facilities

24 Next Steps to Achieve ICSP Establish Partnership Agreements between CCO/RCP and regional institutions that speak to the delivery of integrated cancer services Strengthen regional and local leadership o VP level Designated Cancer Leads for hospitals (RCP Priorities and Planning Committee) o Ensure each hospital has a designated lead for each program/network as appropriate o Establish individual hospital Cancer Committees/Councils to: Review CCO Contractual Agreements Monitor Quality & Performance Metrics and direct quality improvement Ensure network participation and collaboration

25 Next Steps to Achieve ICSP Direct Regional Program and Network physician and administrative leads to develop work plans that address ICSP priorities Implement common oncology-specific information systems to support cancer care integrated with the hospital information systems Put in place infrastructure support to enable integration of cancer services across LHIN o Patient Navigators/Diagnostic Assessment Programs o Interim support to enable cancer care expansion o Obtain support for the integration of the regional networks and programs and their quality improvement initiatives

26 Regional Cancer Integration Coordinator Coordinate the process to create regional integration agreements Coordinate the review and signoff of CCO funding agreements (CSA, colonoscopy,etc.) Coordinate regional network/program meetings and reports Support the organization of regional workshops Coordinate the process for annual work plans Produce an annual report on program and network activities Estimated annual cost $65K

27 Regional Cancer Quality Specialist Support the development and implementation of quality metrics and local quality dashboards at regional hospitals with cancer committees Maintain the dashboard for the regional cancer program and support initiatives by programs/networks to improve metrics Support quality improvement initiatives between partner sites and the RCP Serve as a resource to support regional collaboratives (systemic therapy, colorectal, etc.) Estimated annual cost $130K

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