Background
A study on shared care in breast cancer survivorship has been commenced where individualised care plans are conveniently created using a web-based tool.
Both acute services and general practitioners (GP) have a significant role in surveillance care. Surveillance monitors the risks associated with cancer recurrence, enables patients and all health providers’ expectations to be managed accordingly, promotes early identification and intervention of post cancer psychosocial issues and treatment related side effects, and empowers patients to independently seek healthcare.
Aim
The aim of the study is to promote shared care in breast cancer surveillance, facilitate effective communication between all involved, define responsibilities among healthcare providers and promote the enhancement of healthy lifestyle interventions.
Method
The shared care model is introduced to breast cancer surveillance patients by the oncologist and clinical nurse consultant (CNC). After gaining consent, CNC’s use a web-based tool where patient information is entered into a secure online database and individualised care plans are generated. Care plans include diagnosis information, treatment summaries, follow-up plan, contact details of healthcare providers and request for GP’s to be involved in the promotion of healthy lifestyle interventions.
Results
Shared care using the web-based tool was found to be a safe and preferred model of care among patients. There have been no discrepancies in survival outcomes or delays in cancer recurrence identification. Effectively, a reduction in 11.75 clinic hours has assisted the triage of urgent referrals. Requests for GP intervention regarding healthy lifestyle promotion has led to over 60% of patients accessing allied health services under the Chronic Disease Management plan.
Conclusions
Shared care in breast cancer surveillance can be considered as an acceptable model of care. To improve care coordination, future focus should be directed at restructuring long term follow up between oncology subspecialties like radiation and medical oncologist, and surgeons.