Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Use of Electronic Geriatric Assessment to Facilitate the Enhanced Supportive Care of Older Adults at an Australian Regional Cancer Centre (#489)

Christopher B Steer 1 2 3 4 , Nicole Webb 4 , Stacey Rich 3 , Tshepo Rasekaba 3 , Ben Engel 4 , Craig Underhill 1 2 4 , Sian Wright 5 , Irene Blackberry 3
  1. Border Medical Oncology, Albury Wodonga Regional Cancer Centre, Albury, NSW, Australia
  2. Rural Clinical Campus, Albury, UNSW School of Clinical Medicine, Albury, NSW, AUSTRALIA
  3. John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, VIC, AUSTRALIA
  4. Albury Wodonga Health, Albury, NSW, AUSTRALIA
  5. Hume Regional Integrated Cancer Service, Shepparton, VIC, AUSTRALIA

Introduction:

The evidenced based care of older adults with cancer includes geriatric assessment (GA) to enable treatment decisions and guide supportive care (SC). Clinical implementation of GA is a complex change management process. Electronic GA is feasible and acceptable in the regional cancer centre setting as part of supportive care.

Objectives:

To establish an electronic GA-guided enhanced supportive care (ESC) service for older adults with cancer

Methods:

As a quality improvement process, a project officer was employed and steering committee established. Iterative implementation plan developed using Kotter’s Eight Step Model of Change including creating a sense of urgency, a coalition with local champions and generating short term wins. Existing SC services and GA tools leveraged with focus on sustainability.

ESC model used: G8 screening in new patients aged >70yrs then (if G8 score <14 or age >85yrs) a GA with electronic Rapid Fitness Assessment (eRFA) + mini-COG/clock draw + Timed Up and Go. Questions added: Known to My Aged care? and Presence of Advanced Care Directive?. Results presented at a weekly virtual ESC multidisciplinary meeting (MDM) and appropriate SC referrals made.

Results:

Project officer employed 7/2021 to 6/2022. Key implementation steps:1) multistakeholder GA education programme 2) Moved eRFA to local platform (snapforms.com.au) 3) Empowered all ESC MDM team to conduct eRFA 4) Admin support for ESC MDM.
During the pilot phase (11/2021 to 6/2022) 38 patients underwent eRFA GA and were presented at ESC MDM. Sustainability then proven as ESC MDM continues with a further 102 patients (median age 80yrs (70-97)) presented in the 13 months after project completion. The ESC MDM enables focused and streamlined referrals for supportive care services.

Conclusion:

A two step model with G8 screening then an electronic GA is feasible, acceptable and sustainable in patients aged >70 years. An electronic GA-guided enhanced supportive care service can be created and sustained at a regional cancer centre.