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Current Oncology
Volume 16
Issue 1
10.3747/co.v16i1.297
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Article

A Framework for the Organization and Delivery of Systemic Treatment

by
T. Vandenberg
1,*,
N. Coakley
2,
J. Nayler
3,
C. DeGrasse
4,
E. Green
5,
J.A. Mackay
2,
C. McLennan
4,
A. Smith
6,
L. Wilcock
3 and
M.E. Trudeau
7
1
London Regional Cancer Program, London Health Sciences Centre, 790 Commissioners Road, London, ON N6A 4L6, Canada
2
Cancer Care Ontario’s Program in Evidence-Based Care, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
3
Lakeridge Health, Oshawa, ON, Canada
4
The Ottawa Hospital, Ottawa, ON, Canada
5
Cancer Care Ontario, Toronto, ON, Canada
6
Cancer Centre of Southeastern Ontario, Kingston, ON, Canada
7
Odette Cancer Centre, Toronto, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2009, 16(1), 4-15; https://doi.org/10.3747/co.v16i1.297
Submission received: 8 October 2008 / Revised: 6 November 2008 / Accepted: 9 December 2008 / Published: 1 January 2009

Abstract

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 The environmental scan retrieved published and unpublished sources, coupled with a free key word search using the Google search engine.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.
Keywords: chemotherapy; organizational policy; health care facilities; health care policy; systemic treatment chemotherapy; organizational policy; health care facilities; health care policy; systemic treatment

Share and Cite

MDPI and ACS Style

Vandenberg, T.; Coakley, N.; Nayler, J.; DeGrasse, C.; Green, E.; Mackay, J.A.; McLennan, C.; Smith, A.; Wilcock, L.; Trudeau, M.E. A Framework for the Organization and Delivery of Systemic Treatment. Curr. Oncol. 2009, 16, 4-15. https://doi.org/10.3747/co.v16i1.297

AMA Style

Vandenberg T, Coakley N, Nayler J, DeGrasse C, Green E, Mackay JA, McLennan C, Smith A, Wilcock L, Trudeau ME. A Framework for the Organization and Delivery of Systemic Treatment. Current Oncology. 2009; 16(1):4-15. https://doi.org/10.3747/co.v16i1.297

Chicago/Turabian Style

Vandenberg, T., N. Coakley, J. Nayler, C. DeGrasse, E. Green, J.A. Mackay, C. McLennan, A. Smith, L. Wilcock, and M.E. Trudeau. 2009. "A Framework for the Organization and Delivery of Systemic Treatment" Current Oncology 16, no. 1: 4-15. https://doi.org/10.3747/co.v16i1.297

APA Style

Vandenberg, T., Coakley, N., Nayler, J., DeGrasse, C., Green, E., Mackay, J. A., McLennan, C., Smith, A., Wilcock, L., & Trudeau, M. E. (2009). A Framework for the Organization and Delivery of Systemic Treatment. Current Oncology, 16(1), 4-15. https://doi.org/10.3747/co.v16i1.297

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