Aim:
To improve outcomes of patients > 65 years attending the Onco-Geriatric service at St Vincent’s Hospital Melbourne (SVHM) by providing comprehensive, holistic and integrated geriatric care.
Background
Most new diagnoses of cancer are in older adults. In SVHM, 57% of people with cancer are aged over 65 years. The complex health conditions of older adults with cancer may impede timely diagnosis, appropriate referrals, and maintaining independence, and wellbeing. Their complex healthcare needs means they require extra support to get equitable and timely access to optimal care close to their home.
Method
In August 2021, the Geriatric Medicine and Cancer Services at SVHM, in partnership with Oncology at Goulburn Valley Health implemented the Onco-Geriatric Clinic to provide comprehensive geriatric assessments (CGA) and management plans for older patients with cancer.
The Western and Central Melbourne Integrated Cancer Service (WCMICS) and Hume Integrated Cancer Service (HRICS) assisted in re-designing the clinic. Implementation activities consisted in streamlining referral process to increase access to the service, developing promotional resources, interdisciplinary case discussion for every patient attending the clinic, and tailored management plans based on the CGA assessment.
Results
Since inception, over 70 older Victorians have attended the clinic. Of the 30 SVHM patients who attended, 17 opted for telehealth indicating the success of the model in empowering patients to choose how and where they receive their care.
All attended were enabled in making decisions around their choice for treatments, had assessments of their gait, mobility, cognition, continence, nutrition, and discussion around advance care planning. Personalised plans were developed for each patient, based on individualised interdisciplinary case discussions.
Conclusion
The clinic, one of the first of its kind in Victoria provides integrated care beyond the hospital walls for older Victorians with cancer by sustainable provision of CGA in a timely, person-centred fashion.