Protocol for a mixed methods process evaluation for a nurse-led model of care (SURC) to support individuals receiving systemic anti-cancer therapy

Abstract

Background: The Symptom and Urgent Review Clinic is a nurse-led model of care that has been widely embedded into cancer services across Victoria, Australia. The model was implemented with the primary aim of creating a timely and accessible point of contact for patients and caregivers of patients receiving systemic anti-cancer therapy in the ambulatory setting. Since the initial pilot program to roll out these models in 2018, there are now over 20 Symptom and Urgent Review Clinics across Victoria. This protocol details a study to examine whether the model has achieved its goal of enabling timely access to care, under what conditions, or for what groups of people. Methods: A mixed-methods process evaluation will be undertaken across seven health services in Victoria, Australia. Drawing upon Levesque’s framework for patient-centred access to health care, access to the Symptom and Urgent Review Clinic by people receiving systemic anti-cancer therapy in the ambulatory setting will be evaluated. Quantitative data will be collected by 1) a prospective cross-sectional survey of patients and caregivers; 2) a prospective cross-sectional survey of nurses working within the Symptom and Urgent Review Clinic; 3) a prospective cross-sectional survey of Nurse Unit Managers of Symptom and Urgent Review Clinics and; 4) a retrospective audit of episodes of care of individuals treated with systemic anti-cancer therapy in the ambulatory setting over a 12-month period, and SURC episodes of care over the same time period. Qualitative data will be collected via 1) semi-structured interviews with patients and their caregivers and 2) focus groups with nurses caring for individuals with cancer. An audit of documentation about the model of care available at each site will also be undertaken. Data will be collected concurrently and synthesised at point of interpretation. Discussion: The Symptom and Urgent Review Clinic has been implemented to enable timely access to symptom management support for individuals receiving systemic anti-cancer therapy in the ambulatory setting. The results of this evaluation will provide guidance for future program delivery and evidence of how these models of care can be implemented to enable access to timely care.