444P - Commencing a nurse led symptom and urgent review clinic (SURC) in a Victorian regional cancer centre

Background

In 2017, SURC was introduced in Victoria Australia responding to broader contexts challenges within the health system. SURC’s a nurse led model of care addressing and identifying gaps within an oncology service to support patients experiencing SACT toxicities during the period of active treatment. In May 2020 the Symptom & Urgent Review Clinic (SURC) commenced in Ballarat’s Regional Integrated Cancer Centre. (BRICC) provides health care in the Victorian Grampians Region covering 48,646 square kilometre area. BRICC provides three outreach cancer services to Stawell, Horsham, and Maryborough.

Methods

SURC provides a streamlined process for Oncology patients receiving SACT access to dedicated oncology nursing and medical staff through a single point of access. Patients access SURC from start of treatment, throughout their SACT and 12 weeks after treatment completion. SURC contacts all C1D5 patients, patients discharged from hospital, and shared medical/nursing model of care. SURC referrals were from the medical and nursing oncology team, allied health and other internal and external stakeholders. Patients or their carer could call SURC directly. Workforce challenges in 2022 resulted in SURC setting up a mirrored service supporting BRICC patients in Stawell and Maryborough enabling them to continue having treatment close to home and have their symptoms and toxicities addressed in a timely fashion by an advanced oncology nurse. SURC also became the point of contact for any COVID-related questions and management of patients testing COVID positive.

Results

From May 2020-April 2023 there was 6558 contacts to SURC including telephone calls, clinic presentations, same day ED and day admissions. SURC funding was outpatient WASE 40.52 data activity recorded by IBA. Pre and post SURC data for admitted patients was analysed showing inpatient stay days halved from 686 to 399, reduction in inpatient oncology visits of 104 to 70, as well as readmissions from 4-0.

Conclusions

SURC has improved quality of care and access to specialist nursing and medical advice for patients receiving SACT. SURC provides a single point of access for patients receiving SACT and has also had a significant positive impact on early symptom recognition and management in a timely manner.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Grampians Health Ballarat.

Funding

Has not received any funding.

Disclosure

S. Bartlett: Non-Financial Interests, Personal and Institutional, Member of Board of Directors: CNSA.