A framework for the organization and delivery of systemic treatment
| Autor: | C. DeGrasse, Jean A. Mackay, Theodore A. Vandenberg, Esther Green, J. Nayler, N. Coakley, L. Wilcock, C. McLennan, A. Smith, Maureen E. Trudeau |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
health care facilities Scope of practice business.industry media_common.quotation_subject MEDLINE Alternative medicine Quality care CINAHL Scientific literature systemic treatment Bioinformatics Practice Guideline Series Nursing organizational policy health care policy medicine Chemotherapy Quality (business) Rural area business media_common |
| Zdroj: | Current Oncology Volume 16 Issue 1 Pages 297-15 |
| ISSN: | 1718-7729 1198-0052 |
| Popis: | Background: Increasing systemic treatment and shortages of oncology professionals in Canada require innovative approaches to the safe and effective delivery of intravenous (IV) cancer treatment. We conducted a systematic review of the clinical and scientific literature, and an environmental scan of models in Canada, the United Kingdom, Australia, and New Zealand. We then developed a framework for the organization and delivery of IV systemic treatment. Methods: The systematic review covered the MEDLINE, EMBASE, CINAHL, and HealthStar databases. The environmental scan retrieved published and unpublished sources, coupled with a free key word search using the Google search engine. The Systemic Treatment Working Group reviewed the evidence and developed a draft framework using evidence-based analysis, existing recommendations from various jurisdictions, and expert opinion based on experience and consensus. The draft was assessed by Ontario stakeholders and reviewed and approved by Cancer Care Ontario. Results: The poor quantity and quality of the evidence necessitated a consensus-derived model. That model comprises four levels of care determined by a regional systemic treatment program and three integrated structures (integrated cancer programs, affiliate institutions, and satellite institutions), each with a defined scope of practice and a specific organizational framework. Interpretation: New models of care are urgently required beyond large centres, particularly in geographically remote or rural areas. Despite limited applicable evidence, the development and successful implementation of this framework is intended to create sustainable, accessible, quality care and to measurably improve patient outcomes. |
| Databáze: | OpenAIRE |
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