Poster Presentation COSA-IPOS Joint Scientific Meeting 2012

Localised versus centralised nurse delivered telephone services for people in follow up for cancer: Opinions of cancer clinicians (#768)

James Harrison 1 , Ivana Durcinoska 1 , Phyllis Butow 1 2 , Kate White 3 , Michael Solomon 1 4 , Jane Young 1 5
  1. Surgical Outcomes Research Centre (SOuRCe), School of Public Health, University of Sydney & Sydney Local Health District, Camperdown, NSW, Australia
  2. Centre for Medical Psychology and Evidence-based Decision Making (CeMPED), University of Sydney, Camperdown, NSW, Australia
  3. Sydney Cancer Centre, Royal Prince Alfred Hospital & Sydney School of Nursing, University of Sydney, Camperdown, NSW, Australia
  4. Discipline of Surgery, University of Sydney, Camperdown, NSW, Australia
  5. Cancer Epidemiology and Services Research (CESR), School of Public Health, Univeristy of Sydney, Camperdown, NSW, Australia

Aims: Nurse-delivered telephone services to improve care coordination, clinical and supportive care are methods to supplement traditional clinical follow-up. Telephone services could be implemented locally or from a centralised location. This study explores cancer clinicians’ views about the role of additional telephone services, preferences for localised or centralised models of service delivery and implementation in practice.

Methods: Interviews were conducted with 16 surgeons and cancer nurses across NSW. Content analysis was conducted independently by two reviewers. Data were analysed inductively, responses were organised into categories and then higher order themes.

Results: All clinicians valued the role of additional telephone follow-up as it would allow patients to ask questions, receive reassurance and reinforce information. Clinicians believed these services could reduce emergency department presentations and provide equity and standardised care, particularly to those living outside metropolitan centres.

Although all clinicians accepted a centralised model of delivery would be cost-effective, all indicated a preference for local delivery. This preference was based on the perception that local nurses would have superior knowledge of the local context. Despite the premise of delivering telephone services, clinician’s felt some face-to-face contact with patients was essential.

All clinicians stated that new funding was required given such services did not exist or current staff were overstretched. Key at risk groups where limited resources could be targeted included the elderly, those at high risk of recurrence and culturally and linguistically diverse populations. The timing and intensity of support would depend on tumour type and treatment pathways. Clinicians acknowledged there could be overlap with cancer nurses locally requiring local decisions about implementation.

Conclusion: There was clear endorsement of the benefits of additional telephone support for patients, with a greater preference for a local model of service delivery. The opinions ascertained in this study can be used to translate services into practice.