ABSTRACT
Background: A review of SACT services across SCAN was undertaken from 2016-2108 with the aim of identifying sustainable service models to future proof personcentred, safe and effective care across the network.1 A key objective from the review was to identify a suitable tool which would measure resource capacity within day units and aid future planning. A review of literature identified no off-the-shelf tool therefore a regional group was set up to develop one, building on work completed in West Of Scotland Cancer Network (2018). All health boards and disciplines were represented. The SCAN SACT Capacity & Future Modelling Tool is the outcome of this work and was launched for use in 2020. Methodology • All SACT regimes delivered in day units / Out-patient departments across SCAN listed. • Inclusion of non-SACT supportive interventions. • Chair, nurse, clinical pharmacist and pharmacy isolator resource applied to each regime based on regional time and motion studies and national guidance. • Non-patient facing activities for service delivery identified for inclusion. • Capacity modifiers agreed and included for staff in training, leave, human factors. • Individual unit parameters applied e.g., opening hours, staffing, chairs. • Activity data drawn from local ChemoCare® system. • Regional and Board level validation. • Input from workforce planning analyst team to maximise functionality and usability. • Presented to Regional Workforce Planning Group and Scottish Oncology Pharmacy Group for external input and validation. • Development of a user manual, standard operating procedures and a business-as-usual process for maintenance and bi-annuals updates. Discussion: A beta testing phase was completed by January 2020 to validate formula, content of manual, activity reports and usability. COVID-19 caused a delay in launch, but the tool was updated to include new regimes and was rolled out in 2021. The tool can be customised for individual cancer units and is endorsed at regional executive level for: • Monitoring the impact of activity on chair, aseptic and clinical pharmacy, and nursing resource. • Aiding individual units to model the impact of practice change, service redesign and new medicines. • Supporting the understanding of capacity across the region. Outputs from the tool have contributed to successful business cases for staff, chair resource and to explore the impact of new regimens for formulary applications. Next steps would be to expand the tool to include more trial regimens and explore potential for links with national work streams through interest generated to date. Conclusion: Clinical and management teams are embracing the tool for service planning, moving from a process which focused mainly on numbers and finance to one which interprets those numbers in terms of environmental and human resource. As the patient population we care for and therapies we deliver become more complex this enhancement to service planning supports both patient and professional safety.2.
ABSTRACT
Background/Aims Effective multi-specialty team working is extremely beneficial in management of children with hyper-inflammatory conditions. With the recognition of paediatric inflammatory multisystem syndrome (PIMS) it became apparent a standardised process for discussion of patients would be beneficial. This includes urgent discussion, with access to multiple specialties, and sharing knowledge and experience in a novel condition. Delivering equitable healthcare including access to expertise, specific treatments and research is challenging in Scotland due to its geography. This is facilitated by successful clinical networks (Scottish Paediatric & Adolescent Rheumatology Network [SPARN] and Scottish Paediatric& Adolescent Infection & Immunology National Managed Clinical Network [SPAIIN]) and a well-established paediatric transport service (ScotSTAR). Our aim was to develop a multi-specialty multi-disciplinary team (MDT) for management of patients with hyper-inflammatory conditions. Methods Narrative account of MDT and service development Results We identified a core group of individuals with an interest in inflammatory disorders from different centres and specialties across Scotland including Rheumatology, Infectious Diseases, Cardiology, Intensive Care, Academic Paediatrics, Pharmacists and Clinical Nurse Specialists. Three priorities emerged from initial planning stages: urgent discussions around patient management, peer-to-peer learning and information sharing, and effective prioritisation of research. We designed a written framework and referral pathway, including criteria for acute cardiology involvement, ScotSTAR transfer and intensive care. An electronic proforma was designed to guide MDT discussion, medicolegal documentation and audit purposes. Table 1 describes characteristics of the first nine patients discussed. A particular strength was in diagnostics and consideration of differentials;among patients referred we identified those with haematological malignancy, systemic lupus erythematosus and non-accidental injury. Regular peer-review sessions were held, for reflection on cases and their management in both secondary and tertiary care settings. Clinicians throughout Scotland were encouraged to join via SPARN and SPAIIN networks. Conclusion This multi-specialty MDT has been and continues to be beneficial for management of hyper-inflammatory patients. We will review the process but hope the MDT will prove to continue to be beneficial for future patients. The authors would like to acknowledge all members of the MDT. (Table Presented).