Shared-care model for complex chronic haematological malignancies

Abstract

Myeloproliferative neoplasms (MPNs) are a group of rare Philadelphia-negative chronic leukemias. Disease rarity has resulted in limited expertise concentrated in specialist centres. Patients are often referred to such expert centres for diagnostic issues, complex decision-making, access to novel drugs through clinical trials, and supportive care. Attending such appointments may increase financial and travel burden, increase caregiver stress, and negatively impact quality of life. To address this, the MPN program at Princess Margaret (PM) Cancer Centre has implemented a shared-care model, working with local healthcare providers to provide ongoing management, and supportive care for MPN patients closer to home. This decreases patient travel burden, while maintaining high-quality patient-centered care. In this article we share our experience implementing the shared-care model. This model is potentially applicable to other chronic hematological malignancies and rare chronic diseases. The ultimate goal of shared-care is not to centralize care, but instead to build a community of accessible care for the patient.

Orientation du rôle de l’infirmière clinique spécialisée en oncologie au Centre de cancérologie Princess Margaret

“…Plusieurs articles scientifiques et documents directeurs ont abordé, examiné et évalué le rôle de l'ICS en oncologie (CCO/ ACO, 2018a, 2018b; Dempsey et al, 2016;Kerr et al, 2021;Kilpatrick et al, 2014aKilpatrick et al, , 2014bMitchell et al, 2017;Morgan et Tarbi, 2016;Pollard et al, 2010). Plusieurs publications mettent en lumière l'importance de l'ICS pour promouvoir la coordination et la continuité des soins pour le patient et ses proches aidants, et pour maintenir la communication avec les différents membres de l'équipe interprofessionnelle (CCO/ ACO, 2018a, 2018b; Cheung et al, 2021;Cook et al, 2019;Dempsey et al, 2016). L'ICS aide également les patients et les proches aidants à mieux comprendre le diagnostic et le traitement en leur donnant de l'enseignement sur la santé et en préparant du matériel d'information à leur intention (Kerr et al, 2021;Mayo et al, 2017).…”

“…L'ICS aide également les patients et les proches aidants à mieux comprendre le diagnostic et le traitement en leur donnant de l'enseignement sur la santé et en préparant du matériel d'information à leur intention (Kerr et al, 2021;Mayo et al, 2017). De plus, en triant efficacement et rapidement les nouveaux cas, les ICS améliorent la sécurité des patients (Cheung et al, 2021;Cook et al, 2019;Moore et McQuestion, 2012).…”

Guiding the Clinical Nurse Specialist role in oncology within Princess Margaret Cancer Centre

“…The CNS role in oncology has been explored, evaluated, and discussed in various journal articles and guidance documents (CCO, 2018a(CCO, , 2018bDempsey et al, 2016;Kerr et al, 2021;Kilpatrick et al, 2014aKilpatrick et al, , 2014bMitchell et al, 2017;Morgan & Tarbi, 2016;Pollard et al, 2010). Several publications highlight the value of the CNS role in promoting coordination and continuity of care for the patient and their caregivers and maintaining communication with the various members of the interprofessional team (CCO, 2018a(CCO, , 2018bCheung et al, 2021;Cook et al, 2019;Dempsey et al, 2016). The CNS role also fosters improved patient and caregiver understanding of their diagnosis and treatment through providing health teaching and creating patient education material (Kerr et al, 2021;Mayo et al, 2017).…”

“…The CNS role also fosters improved patient and caregiver understanding of their diagnosis and treatment through providing health teaching and creating patient education material (Kerr et al, 2021;Mayo et al, 2017). CNSs also improve patient safety through effective and timely triaging of new patient referrals (Cheung et al, 2021;Cook et al, 2019;Moore & McQuestion, 2012).…”

Cardiorenal metabolic syndrome: reaching a consensus in shared care

“…It has demonstrated a reduction in emergency admissions, whilst creating a community of practice to encourage safe care delivery near home environments, and improvements in patient satisfaction and quality of life, (Chumbler, et al, 2007, Gorin et al, 2017. Cheung et al's (2021) international study of shared care models for chronic complex haematological diseases champion the benefits of providing ongoing management and supportive care through this method of delivery and indicates this may be transferrable. However, a caveat for success is the provision of dedicated resources in the form of a single point of contact, clear definition of roles and responsibilities within healthcare teams and appropriate care coordination, to ensure communication channels remain open to all, (Cheung et al, 2021).…”