Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

The CARE PLUS Implementation Toolkit: A set of resources to guide successful implementation of early palliative care in advanced cancer care (#55)

Jennifer Philip 1 2 3 , Kylee Bellingham 2 , Nicole Rankin 4 , Farwa Rizvi 2 , Mei Krishnasamy 5 , Gregory Crawford 6 , Anna Collins 2 , Geoffrey Mitchell 7 , Anna Nowak 8 , Vijaya Sundararajan 2 , Brian Le 3
  1. St Vincent's Hospital, Fitzroy , VIC, Australia
  2. Medicine, University of Melbourne , Parkville, Victoria, Australia
  3. Palliative Care, Melbourne Health, Parkville, Vic, Australia
  4. School of Population and Global Health, University of Melbourne, Parkville, Vic, Australia
  5. School of Nursing, University of Melbourne, Parkville, Vic, Australia
  6. Medicine, University of Adelaide, Adelaide, South Australia, Australia
  7. Medicine, University of Queensland, Brisbane, Queensland
  8. Medicine, University of Western Australia, Perth, Western Australia

Background: Despite global evidence for the benefits of early palliative care integration into advanced cancer care, there remain gaps in translation, with limited information about the effective implementation strategies to effect this practice change.

Aim: To introduce the Care Plus implementation toolkit package as an online resource, supporting the implementation and sustainability of palliative care integration into cancer services.

Design, methods: Guided by the Medical Research Council methodological framework for developing complex interventions, Care Plus, a model of early palliative care designed to address known implementation barriers, was delivered through a multi-site stepped wedge, mixed methods implementation study across four Victorian and South Australian hospitals. We conducted qualitative interviews with palliative care consultants, oncologists, nurses, patients and carers to understand implementation approaches and their utility. We developed an implementation toolkit based on data outputs from healthcare providers to operationalise a standardised approach to early palliative care for advanced cancer patients in their own organisations.

Results:  Interviews with 49 participants in the Care Plus study highlighted the effective implementation strategies to establish and evaluate the outpatient-focused Care Plus model co-designed with relevant clinical teams. The Care Plus implementation toolkit (https://www.careplusau.org/about-5) was then developed as an online resource, guiding the implementation of the pathway through three phases: Planning and Engagement, Implementation, and Maintenance.  The implementation strategies, core activities, and supporting materials directly address barriers to why, who, when, and how patients can access early palliative care at pre-agreed nominated trigger points with organisational processes flexible to local context.

Conclusions/lessons learned: The Care Plus toolkit (free online), developed using a data-driven approach, offers improved understanding of strategies to underpin successful systematic implementation, translation and ongoing evaluation of early integrated palliative care models in cancer practice.