Background

Patient-centred models are required to assist growing numbers of survivors transition to community based care. From 2011-2013 the Victorian Cancer Survivorship Program (VCSP) funded six 2.5-year pilot projects to develop, implement and evaluate post-treatment models of care. Projects were conceptualised in acute care, targeted different population groups, utilised partnerships with community and existing funding streams.

Aims

To identify key learnings from project outcomes, enablers and challenges to inform the future development of effective, sustainable and transferable models of care.

Methods

A thematic approach was used to identify common implementation learnings, enablers and challenges across the projects. Project outcomes were considered individually in the absence of a shared evaluation framework.

Results

Outcomes included: increasing receptivity to survivorship care and improved understanding of different populations; developing partnerships with primary care; successful transition to shared care for risk stratified survivors; resource development; utilisation of chronic disease models and a shift towards a self-management support approach. Absence of control groups and dissimilar interventions precluded comparison of interventions. Limited timeframes and outcome measure selection impacted the strength of some findings.

Common enablers included: clinical leadership; utilising partnerships with consumers, primary care and community organisations; risk stratification pathways with rapid re-access to specialist care; early preparation for survivorship, self-management and shared care; workforce education and infrastructure/resources to support models.

Shared challenges identified: reorienting to a culture of shared care; primary care engagement; diverse survivorship populations and needs and limited resources (information technology and staffing). A lack of sensitive, valid outcome measures impacted program evaluation.

Conclusions

The projects highlighted key learnings for implementing and evaluating survivorship interventions. Extended timeframes were required to embed new models and evaluate outcomes. Future projects should consider identified critical enablers and challenges and use of a single evaluation framework.