1. PREPARED BY The New Zealand Cancer Nurse Coordinator Initiative Natalie James National Nurse Lead May 2013

2. Welcome to the role… The Cancer Nurse Coordinator role aims to: Improve patient care through o timely diagnosis and initiation of treatment o continuity of care o facilitating a quality experience, equity and patient and family empowerment Service improvement Workforce development

3. CNC’s - Specialty practice

4. Evolving Practice… These Cancer Nurse Coordinator roles support a new model of nursing care o Collaborative practice o Local / Regional / National o Evaluation Essentially establishing key functions or components of the role o Specialised skills and processes o Resources and tools o Plan of care / pathways

5. Building on what is known…

6. Established modes of care Canada Australia USA UK

7. Building on work of others Needs Assessment – Who are the population to be served? High risk Rare cancers Multiple comorbidities High volume Groups – tumours, age geography Where do patients come from What are the existing resources (Crane-Okada, 2013)

8. Building on work of others Validation of a framework to clarify key role and function (Fillion et al, 2012) Facilitating continuity of care Continuity of information (medical) Management continuity –consistent approach Relational continuity – therapeutic relationship Promoting patient and family empowerment Active coping Cancer self-management Supportive care

9. New Zealand roles 44 cancer nurse coordinators have been appointed in part- time and full-time positions across 16 DHB’s 4 approaches Generalist Tumour stream Population group Stage of cancer, clinical need

10. New Zealand roles CNC’s must remain mindful approach to care coordination should include: Equity lens Consumer view Provider engagement

11. Supporting role development Communication and collaborative practice: Newsletter – national newsletter for CNC’s o topical information o Faster Cancer Treatment info o resources Website dedicated CNC webpage o contact information and profiles o organise resources and tools o support orientation

12. Supporting role development Regional Meetings o provide peer support, review systems and processes, progress initiatives o education o formal process National Forum / Meeting o support national collaboration o highlight successful initiatives o review tool development

13. Supporting role development.. Successful initiatives are promoted and will be shared nationally Ministry and Lead Nurse will support development of tools resources High level of interest and protocol around sharing outcomes and stories

14. National Identity - Branding

15. Tools and Resources Assessment and triage Identification of a complex patient Screening for distress and support need assessment Referral processes Hand-held records MDM communication Health information Mapping the patient journey Orientation of new CNC

16. The National Nurse Lead Support implementation of the roles o National consistency / regional approach Professional leadership Lead development of tools Clinical Leadership to champion service improvements

17. Cancer nurse coordinator evaluation Evaluation Purpose The evaluation will assess implementation of the Initiative against two overarching aims: Improving the experience for patients, including their family/whānau, with cancer or suspected cancer. Improving overall access and timeliness of access to diagnostic and treatment services for patients with cancer.

18. Cancer nurse coordinator evaluation Evaluation Framework The evaluation has two components: Process evaluation – reviewing how the Initiative was implemented and operated. This will involve an in-depth assessment of the initiative activities during the development stages and operation of the initiative over three years Impact evaluation – assessing whether the Initiative achieved its goals and objectives, measuring the value added to service users and families/whānau, health professionals and regional cancer programme development and utilisation..

19. Cancer nurse coordinator evaluation Proposed data collection The evaluation will use a ‘mixed methodology’ approach to collecting information. It is anticipated that the four main data sources will be: patient clinical pathways case studies online stakeholder survey patient satisfaction survey analysis of Ministry/DHB datasets

20. Cancer nurse coordinator evaluation Upcoming deliverables baseline report is due in July 2013 first annual report is due in January 2014 final evaluation report is due January 2016

21. Questions and Discussion