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PROVINCIAL ONCOLOGY

NURSING NEWSLETTER

Winter 2015 11TH EDITION

Dear Colleagues,

As I step down

from the role of

Provincial Head, Nursing and

Psychosocial Oncology, I want to

share some perspectives on

what we have accomplished by

working together, and suggest a

few areas that you might want to

pursue in the future. When I first

came to Cancer Care Ontario,

there was a network of nurses

established to work on a few initi-

atives, such as the Systemic

Treatment Workload estimates.

Despite this, a consensus was

made that we needed to create a

stronger focus in oncology

nursing to better serve the needs

of cancer patients and their fami-

lies. This marked the beginning

of the Oncology Nursing

Program and Committee

(ONPC).

One of the first areas of concern

to you as nursing leaders was

the ability to manage patients

remotely as they were having

symptoms and needing nursing

guidance. This was ground-

breaking as it was the first focus

on remote assessment and inter-

vention on symptom manage-

ment that preceded the origins of

the Ontario Symptom Manage-

ment Collaborative. In Ontario,

assessing patients remotely was

determined to be within the

scope of practice of RNs, and

supported by the College of

Nurses in Ontario. Together we

developed a guidance document

on Telephone Practice that out-

lined several symptoms that can-

cer patients experienced, such

as pain, and dyspnea, providing

clinical approaches to remote

assessment. We evaluated the

approach, which was led by

Dawn Stacey at the University of

Ottawa, and found that there

were variations in how the tool

was used. Several recommen-

dations arose from this work that

improved the ways in which nurs-

es could assess patients’ symp-

toms. Ultimately, Dawn and her

colleagues were able to secure a

large knowledge translation grant

that allowed them to develop the

tools and expand the reach to

provinces across Canada. This

initiative became the pan-

Canadian Oncology Symptom

Triage and Remote Support

(COSTaRS).

Building on the first initiative on

guidance support, we worked

with the Program in Evidence

Based Care (PEBC) to develop

the first nursing guideline on

Central Venous Access Devices.

Several guidelines followed this

sentinel work: Cancer Related

Pain Management; Nursing of

Patients with Non-Small Cell

Lung Cancer. Most recently,

nursing has been involved in the

development of evidence

guidelines in safety, such as the

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Inside this Issue:

Farewell from Esther Green……………………1-3

Oncology Nurses: Engaging for Excellence……..

…………………………………………………….4-5

Meet our New Patient Family Advisors!….......6-7

Meet your Colleague: Carol Gunsch…………….7

The Importance of Navigation …...……………...8

Fostering Leaders in Oncology and Palliative

Nursing……………………………………………..9

Oncology Nursing in New Ambulatory Models of

Care…………………………………………..…..10

Reflections of Oncology Nursing in Ontario over the past 12 Years

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Safe Handling of Cytotoxic Agents

(most recent release in 2014);

Safe Labelling; Safe Administra-

tion of Chemotherapy, Part 1 and

Part 2. The importance of these

guidelines cannot be understated;

patient and staff safety are integral

to quality of care and the recom-

mendations from the guidelines

can be applied to all practice

settings. Now we are able to

assess concordance with these

guidelines to identify where there

are areas for quality improvement.

All of these guidelines were

developed in partnership with

other clinical programs and

disciplines, such as the Systemic

Treatment Program, pharmacists,

medical oncologists, administra-

tors and others. We are part of the

interdisciplinary focus on quality.

One area that we continue to ex-

plore is in advanced nursing prac-

tice. Over the past few years, we

hosted think tanks and workshops

to explore the role of Advanced

Practice Nurses (APN); and partic-

ipated in research studies led by

Denise Bryant Lukosius. Denise’s

work on the development of the

Participatory Evidence-Based

Patient Focused Process for

Advanced Practice Nursing Role

Development (PEPPA) provided

the foundation for several research

grants; for example, the use of the

PEPPA framework to examine

capacity building for effective

implementation of oncology APN

roles in underserviced populations;

determining ways to plan for health

human resources by examining

how oncology APNs are situated in

practice settings. A new guideline

will be released soon on the

Effective Use of Advanced

Practice Nurses in Cancer Control.

This guideline is based on a

systematic review of evidence of

the ways in which APNs have

provided care in screening,

treatment, palliative care and

survivorship. A symposium is

being planned to consider how to

apply the recommendations across

the cancer system.

The de Souza Institute was creat-

ed in 2008 with funding from the

Ministry of Health and Long Term

Care. This was established with a

focus on oncology nursing, to

facilitate the development and

expansion of this specialty area of

practice. The de Souza team has

done outstanding work in creating

innovative programs for nurses

across Ontario, using a platform

for learning that exceeds what

universities and colleges have for

student learning. The de Souza

team worked very closely with

CCO and the ONPC to: embed

evidence based guidelines in each

course; respond to new initiatives

such as the Nurse Navigator role;

develop a provincial standardized

curriculum in chemotherapy and

biotherapy with a focus on care of

the patient; expand learning in

psychosocial support for nurses;

support nurses in preparation for

the national certification exams in

Oncology Nursing or Hospice

Palliative care nursing; and create

the de Souza designation. More

than 6000 nurses have participat-

ed in the courses and several

nurses have completed the de

Souza designation, across the

regional cancer centres and

community hospitals.

In 2005, a report highlighted the

opportunity to consider the role

that RNs can play in assessing

patients in the age-eligible popula-

tion for colon cancer screening.

Through a grant, the role of RNs

using Flexible Sigmoidoscopy was

piloted and based on the success

of the study, sites were selected to

begin the use the RNFS initiative.

A training program that included

knowledge, clinical skills, clinical

judgement and simulators to

perform the procedure was

designed to support the nurses.

Evaluation of the program has

revealed the success of this

initiative in several sites across

Ontario; and it is anticipated that

this new role can be utilized in

more sites in the future, as part of

the Colon Cancer Check program.

This initiative highlighted the

importance of considering new

roles for nurses.

Nurse navigator roles were devel-

oped and tested within the

Diagnostic Assessment Programs

(DAPs). Early results demonstrat-

ed the success of the role in

ensuring that patients were able to

be diagnosed more timely than in

the past, and navigated the com-

plex system with greater ease.

There are Nurse Navigators in

DAPs in each of the regions; the

first initiative introduced the Nurse

Navigator role in Lung and Colo-

rectal DAPs. Many of the DAPs

have established Navigators in

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additional disease sites, such as

Prostate, Breast and others.

Building on work in the US and

recognizing that the initial attempt

to define nursing workload related

to systemic treatment needed to be

updated, the ONPC collaborated

with administrators, nurses in

chemotherapy suites, pharmacists,

health economists and others to

design what became known as

Resource Intensity Weights (RIW).

This work focused on what

resources were needed to safely

administer chemotherapy to

patients and included all elements

of care: teaching, assessment,

monitoring, administration, and

follow-up; and focused on these

elements in relation to each proto-

col. This was a difference from the

original work in 1999, which

focused on number of nursing

hours per year in chemotherapy

suites. The challenge that nurse

managers and others found was

that as protocols changed and

were more complex in delivery, the

nursing hour estimates were out of

date. Since the first work on the

RIW, the protocols, definition and

methodology are reviewed annual-

ly. More recently the group has

undertaken to develop RIW related

to oral chemotherapy.

Symptom assessment and man-

agement is one of the fundamental

activities of oncology nurses. The

Ontario Cancer Symptom

Management Collaborative

(OCSMC) team recognized the

importance of nursing roles and

worked with nurses and other clini-

cians to develop guides to

symptom management to support

practice. The de Souza Institute

worked with experts in the field to

develop specific courses in

dyspnea, pain and depression to

educate nurses and others to build

more capacity to assess and

manage patient symptoms. In

addition, a small working group of

nurse leaders worked tirelessly to

develop tools and resources to

support nursing documentation in

ambulatory oncology. These tools

and resources included assess-

ment and interventions in symptom

management.

In March 2014, nurses and their

interdisciplinary team members,

administrators, patients and family

advisors were invited to participate

in a symposium focused on ‘Right

Care, Right Provider’ in ambulatory

cancer care. One of the considera-

tions for this work is the concept of

scope of practice and best utiliza-

tion of health human resources.

There are myths about what

nurses can do in patient care; and

among other discussions on value

mapping, the recognition of nursing

scope of practice became

apparent. The work from this

initiative outlined several

recommendations that are being

considered by the Models of Care

program as this team moves

forward to support the develop-

ment of new models of ambulatory

care.

Where to now? There are many

areas of work to improve the

patient experience. The need for

the safe and effective delivery of

chemotherapy in the patient’s

home is one area that has been

highlighted in the new provincial

Systemic Treatment Plan. As

highlighted above, there are

opportunities to plan health human

resources in new ways to focus on

patient care, as the work on

models of care unfolds; for exam-

ple, looking at expansion of nurse-

led clinics; or provision of access

to 24/7 symptom assessment and

intervention, a priority highlighted

by patients across the system.

The notion of creating new roles,

given the success of Navigators

and RNs in flexible sigmoidoscopy

could be considered in the context

of patient care; the right provider at

the right time.

CCO has been an amazing place

of work for me. I am grateful to

many people without whose

support none of us would have

been successful. All the nurses in

oncology who have contributed

their time and expertise need to be

recognized. The program staff at

CCO are an amazing team of

individuals who made the right

things happen, as my colleague

said, they created the ‘art of the

possible’. I thank them for their

support and allowing me the time

to work with them.

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Oncology Nurses: Engaging for Excellence

Tracey...

I never wanted to be a nurse. Never in my wildest dream did I think I would become one. I did not know what a nurse did, nor did I know any nurses. Neither my mother, nor my aunts were nurses; this was never in the realm of pos-sibilities. It is interesting how life’s altering moments can change your path completely. My decision came simply one sunny afternoon, browsing through a college magazine; I was looking at my course options and the decision was made. The rest was history as they say.

I have been an oncology nurse for a long, long time. In fact, the first ten years of my career I nursed patients who had surgery after a cancer diagnosis. It is funny, back then I did not consider myself an oncology nurse, rather I was a surgical nurse. The change to oncology occurred when I realized that I was tired of what I was doing and needed a change. This was the best decision I ever made as a nurse.

What I do is special. I am often asked, “How can you work in such a sad place?” Actually, it is the far-thest thing from sad. We often laugh and try to make our work-place upbeat. I have the distinct pleasure and privilege to meet and work with many different patients and their families. It is an honour to laugh with you and occasionally cry with you. Each and every one of you has made me realize how precious life is. I could not imagine doing anything else.

Tracey Kerr RN BSN CON(C) Durham Regional Cancer Centre

The World Through My Eyes

I am an Oncology Certified Nurse. Everyday I park my car. I walk through the many hallways of the hospital and go towards the door of my work. They are doors that separate the "Real" world from a world of Wonder.

WORLD OF WONDER:

Every day at work I travel to differ-ent places in the world as my pa-tients tell me about where they were born or where they have trav-eled. At times I can even eat the food of these foreign places when they are brought in for our enjoy-ment. I learn about world history and talk about politics. I have glimpses of my patient's life on the outside; friends, family, and pets. I laugh at the good jokes and

the bad ones. I share their anxie-ties and fears. I am happy when they go and never come back because they are "better". When they come back because the cancer has come back, I mentally give them a hug and continue where we left off. I have met, laughed and loved more people in the few years I have worked in on-cology then I have all the other years of my life. I have "lost" more friends in these few years then I have in the other years of my life. My patients have helped me become the person I have always dreamed of being.

REAL WORLD:

Every day I sit at my work station and I look over my work assignment. I give people chemotherapy and

I make sure they are okay before they go back home. I get two thirty minute breaks. I prepare for my next work day and then I go home.

Anna Misseri RN CON(C) Durham Regional Cancer Centre

“Why do I come to work every day?

Simple, because I make a difference.”

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On April 1, 2014, Oncology Nursing Day, we asked oncology nurses across Ontario to share their stories with us as a

way to highlight and recognize their excellent work every day. Included below are nursing stories from Durham

Regional Cancer Centre.

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I Come to Work to Make a Difference

I come to work every day be-cause I know I can make a differ-ence. I feel for each and every person who walks through our doors. Not only the "chemo" pa-tient, but their loved ones as well. These are real people, having a real experience that is causing fear, pain and sadness for them and their families. But we can try to make them feel confident and cared for from the moment they step through those doors. I give excellent care, and have an excel-lent team to work with. Not only the other nurses, but the doctors, the pharmacist, the social workers, the dietitians, the volunteers, the

SSA's, the manager and everyone else who I may have forgotten to add. We all play a huge role in making this experience for patients really a "patient first" environment.

I know that my patients receive the best knowledgeable care, and I know that I can give that to them. I may not always be the chattiest person, but when I ask a patient how they are doing, I genuinely mean it. As an oncology nurse you get to know your patient, they come through those doors, every day, once a week, every two weeks, or every three. I have cried for patients, I have worried about patients when I don't see them for a while, I have laughed with patients, and I have talked with patients. I really get to know some

of my patients and their families. I can see that look sometimes when you ask them how they are and they say "I'm ok" and you know they are not, and then they will open up to you, tell what is go-ing on in their life be it "chemo" related or not. And whatever it may be I will try to help them, or put them in contact with someone who can. Sometimes they just need to have a good cry... and that's ok.

So my point is they aren't just pa-tients to me, they are people who need someone to help them, and I get up and come to work to do just that.

Kristen Lehtinen RN BSN CON(C)

Durham Regional Cancer Centre

Find a Job you Love

Patients often say to me "Your job must be really depressing". I tell them, surprisingly, it isn't depress-ing at all and I love working here.

I've never particularly contemplated why I love my job. I just do. There's the old cliché 'I love to help people'. That’s why we all went into nursing in the first place. Helping people is my job but it isn't why I come to work eve-ry day. If that were so, I probably would have burned out years ago. Eventually the need to help people evolves into something diffi-cult to articulate. As simply as I can put it, I come to work every

day because of what my patients ‘give’ to me. I don't mean their ap-preciation or gratitude or cookies at Christmas. What I mean is, my patients ‘give’ me a sense of pur-pose and accomplishment, a feel-ing that I’ve made a difference to them.

I know I make a difference every day. But knowing that I’ve made a difference in my head is much dif-ferent than feeling I made a differ-ence in my heart. There’s a huge sense of pride that comes from making a difference. In many ways, it’s an emotional high. Who doesn’t want to feel good? So, as much as I come to work to make a difference for my patients, selfishly I also come to work to feel good about making that difference.

There are many patients who have given me this feeling, too many to

count. These are the patients that have taken me along their journey and ‘given’ me a special place. They’re the ones that have told me they’ve progressed and wondered how they were going to break it to their husband; the ones who’ve scribbled me a note on a bagel wrapper in the cafeteria and sent it back with a co-worker for me to read; the patients who tell me they “missed” seeing me their last visit. In those moments, I can feel I’ve made that difference and it feels great!

Laurie Young RN CON(C) Durham Regional Cancer Centre

Oncology Nurses: Engaging for Excellence

“Find a job you love and you will never have to work a day in

your life.” Confucius

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Meet Our Patient Family Advisors!

Linda Selig

H i, my name is Linda Selig, I

am 68 years old, a wife, mother,

grandmother, former nurse, avid

traveller, curler and gardener.

My cancer journey began in 2006

when I was diagnosed with stage

1 breast cancer. I was fortunate

because I found it early, it was

not aggressive and with

lumpectomy, radiation and

tamoxifen I was cured. It is easy

to say this now, but at the time it

was terrifying and despite having

a supportive family, I sometimes

felt alone. After my treatment I

learned about the Cancer

Society's Peer Support program

and became a volunteer so that I

could help other women going

through this traumatic

experience.

In 2010, my husband was diag-

nosed with multiple myeloma and

underwent a stem cell transplant.

Unfortunately, for him there is no

cure, he has to live with the

disease, and the side effects of

his treatment, every day. Being

his caregiver is sometimes

challenging.

I am now a caregiver support

volunteer for those caring for

someone with a blood cancer or

transplant. For the caregivers,

just being able to talk openly and

honestly about their fears,

frustrations, and pain –which they

often feel they cannot do with

family members– can help a lot.

Since I have been doing this I

have become increasingly aware

of the complex psychosocial

issues that these families face, in

addition to their medical needs.

Since 2011, I have been a family

representative on the CCO Stem

Cell Steering Committee and this

led me to apply to the Oncology

Nursing Program. I hope that my

experiences as a patient, caregiv-

er and a volunteer will enable me

to contribute in a meaningful way

to the committee.

Tamara Levine

T amara Levine from Ottawa,

recently celebrated five years

since being diagnosed with an

aggressive breast cancer. Healthy

and cancer-free since 2010, she

became a Patient and Family

Advisor (PFA) to Cancer Care

Ontario last year and joined the

Oncology Nursing Program Com-

mittee as a PFA in June, 2014.

Prior to her diagnosis, she worked

as an adult educator in the labour

movement in workplace literacy,

clear language and labour

education.

Her book, But Hope is Longer:

Navigating the Country of Breast

Cancer, was published in 2012 by

Second Story Press. Based on

letters she wrote throughout her

“year from hell”, it touches on sev-

eral themes: becoming captain of

her own ship, straddling main-

stream and complementary can-

cer care, facing mortality, finding

strength in vulnerability, learning

to receive support, etc. It includes

the chapter Voices of the Healers

based on interviews with her

oncologists, surgeon, oncological

naturopath and life coach about

their work with cancer patients. It

explores the need for better navi-

gation and co-ordination within the

cancer care system and imagines

what it will take to bring about a

world without cancer (see http://

secondstorypress.ca/books/243-

but-hope-is-longer).

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Tamara is committed to bringing

what she has learned from her

experience to make cancer

care the best it can be for

patients. In addition to her

book, she has written several

articles and given book talks at

libraries and bookstores. She

has shared her experience

with new breast cancer

support groups and nursing

students. She developed the

workshop Navigation Lessons:

Getting on Track after a

Cancer Diagnosis and is

working with the Ottawa

integrative Cancer Centre

on their Headstart Program

for newly diagnosed breast

cancer patients. She is a

member of the Patient Family

Advisory Committee to

Cancer Care in the

Champlain region.

Married with two adult chil-

dren, Tamara loves to sing,

write, walk, cycle and

swim and is learning to play

the ukulele.

Meet Our Patient Family Advisors!

Carol Gunsch

C arol Gunsch, a Registered

Nurse from Grand River Regional

Cancer Centre is the very first de

Souza Designate. Carol began

working towards her de Souza

Nurse Designation in 2008. After

completing four credits from each

of the four domains and a two

week clinical fellowship she

was honoured with a

plaque showcasing her specializa-

tion in 2012.

Carol devoted herself to furthering

her oncology knowledge and

completed her Designation to help

ease the experience for cancer pa-

tients while they went through the

cancer journey. Carol Gunsch is

grateful for the guidance and men-

torship that de Souza Institute has

offered to help enhance her exist-

ing clinical skills. Carol shares

more about her experience in a de

Souza Nurse video at the following

link:

http://www.desouzainstitute.com/

press-releases/become-de-souza-

nurse

Carol has worked as a dedicated

Registered Nurse Navigator in the

GI Diagnostic Assessment

Program at Grand River Regional

Cancer Centre in Kitchener,

Ontario. Carol is the first nurse

to have obtained a de Souza Des-

ignation in Ontario.

Meet your Colleague!

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New and Returning CCO Nursing Program Staff

Zahra Ismail

Program Manager

PSO, Nursing and Patient

Education

Amanda Yumbla

Senior Administrative Assistant

Psychosocial Oncology, Nursing

and Symptom Management

Monika Duddy

Project Coordinator

PSO, Nursing and Patient

Education

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New Program in Evidence Based Care (PEBC) Guideline!

The “Effective Use of Advanced Practice Nurses in Cancer Control” guideline is currently in the final stages of external review and anticipated to be released in March 2015. Based on comparative studies, the guideline provides recommendations on which patient populations and in which situations APNs are shown to be effective cancer care providers, demonstrating either equivalence, reduced harms, or improved out-comes. Cancer Care Ontario is planning a Knowledge Transfer and Exchange event to help share the guideline recommendations. Watch out for a briefing note summarizing the key recommendations in the near future!

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NURSE NAVIGATION: Patient Case Study

S hortly before Christmas I received a referral to our Lung DAP for a 71 year old gentleman. His attached CT scan showed “a large malignant mass in the left lung.” I called his home to explain what my role was. His wife answered and informed me that her husband was resting and unable to come to the phone.

At this point she paused for a few moments and started to cry. She said “I don’t know why I should bring my husband to the appoint-ment anyway. We saw our doctor yesterday who told us my husband has cancer in his lungs that has probably spread to other organs and cannot be cured. Why does he need a biopsy if he is going to die anyway? I don’t want to put him through anymore and I feel totally overwhelmed.”

I attempted to normalize her feel-ings. I agreed with the doctor that

the CT scan was highly suggestive of lung cancer but the only way of knowing the cell type was to have a biopsy. I assured her that even if this was an incurable situation there were treatments that could improve her husband’s quality of life. I moved on to assessing his symptoms using the ESAS scale. I was relying on her perception of her husband’s symptoms. She felt his pain was controlled on medica-tion he started the day before. Our conversation took place late in the day and I told her I would call her in the morning to follow–up.

About ten minutes later I received a call from their daughter. When I reviewed her father’s symptoms with her I became very concerned that he had a spinal cord compres-sion as well as a DVT. I informed her of my concerns and instructed her to have him assessed in the emergency department . She did as I suggested and within 18 hours of our first conversation he had

started radiation treatments. He was admitted to Palliative Care where his symptoms were con-trolled and he eventually was discharged home with the proper resources in place. He died peacefully three weeks later.

Without early intervention of a Nurse Navigator the outcome for this family could have been much different.

Susan Lee RN CON(C) Nurse Navigator Royal Victoria Hospital

The Importance of Navigation

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In partnership with CCO,

University Health Network and

the Ministry of Health and Long-

Term Care, de Souza Institute

created and launched the de

Souza Designation program in

2012. The Designation is

modelled after the MacMillan

Nurse in United Kingdom, and

showcases advanced

knowledge and expertise in

cancer and palliative care.

The creation of the de Souza

Nurse Designation program is a

direct response to the need for

a more specialized workforce to

manage complex cancer care.

Nurses form the majority of the

health care workforce. Ongoing

systematic and standardized

workforce training is imperative

to support new graduates to

become familiar with the

specialized knowledge, and for

experienced nurses currently in

oncology to obtain and lead the

implementation of the latest

best practices. Because of the

life threatening nature of

cancer, oncology nurses not

only need to master safe and

effective administration of

nursing procedures, but also

attend to the emotional needs of

patients and families and offer

holistic person centered care.

de Souza Designations build on

the oncology nursing competen-

cy standards released by the

Canadian Association of Nurses

in Oncology (CANO) and map

continuing education supports

into domains of nursing excel-

lence in treatment, psychosocial

care, patient teaching and

education and professional

development. There are four

levels of designations:

de Souza Nurse Associate for

generalists, de Souza Nurse

for specialized nurses,

de Souza APN and de Souza

Scholar for nurse educators

and leaders. Each Designation

requires nurses to complete

more than 150 hours of

de Souza Institute courses in

cancer and/or palliative care.

Designations such as de Souza

Nurse requires a CNA specialty

certification and a clinical fellow-

ship, while de Souza APN

includes an additional research

project to further support

nursing capacity building and

leadership.

The learning pathway towards

each of the designations is

supported through de Souza

Institute’s innovative online

courses that are updated

annually based on the latest

evidence and the most recent

CCO guides to practice. Experi-

enced clinician educators

facilitate de Souza courses that

are designed to be clinically

meaningful and that incorporate

case studies and application

illustrations.

To date, 16 nurses have

obtained a designation, with

another 100 nurses working on

their final course credit towards

obtaining the designation in the

near future. “All health care

professionals are challenged to

keep pace with new evidence

and approaches to treatment.”

said Dr. Mary Jane Esplen,

Director of de Souza Institute.

“These recent “de Souza

designates” are health care

professionals, who despite

years of experience, recognize

the need for ongoing updates

and training in order to deliver

quality care, and are held in

high regard.”

Working with its local and

provincial partner organizations,

de Souza Institute will continue

to support every nurse in Ontar-

io, regardless of geographic

area or practice role, to work

towards a designation and will

assist in fostering a culture of

lifelong learning across the

nursing community of practice.

For more information, visit

www.desouzainstitute.com

Jiahui Wong, MSc, PhD

Scientist and Manager,

de Souza Institute

Fostering Leaders in Oncology and Palliative Nursing

A Review of de Souza Nurse Designation Program

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If you have any questions or concerns about the content of this newsletter or the Provincial

Oncology Nursing Newsletter or would like to contribute in the future, please contact

Monika Duddy, Project Coordinator at Monika.Duddy@cancercare.on.ca or 416.971.9800 ext. 2284

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Oncology Nursing in New Ambulatory Models of Care

An Outcome-Driven Interdisciplinary Workshop

T he number of Ontarians diag-

nosed with cancer is steadily

rising each year, requiring the

healthcare system to deliver more

high quality services with available

resources. Building a more

effective healthcare system is a

collective effort and together, we

need to rethink the way we deliver

cancer services in Ontario today

and in the future.

On March 7, 2014, CCO held the

“Right Care by the Right Provider:

Oncology Nursing in New

Ambulatory Models of Care

Workshop”, which brought

together people from across the

province and across the

healthcare system to begin the

dialogue on how cancer care is

organized, and how to best meet

the needs of patients. This interac-

tive, all-day session engaged

patients, healthcare providers, and

system partners in identifying

future models of ambulatory care

focused on the role of oncology

nursing within an interdisciplinary

team. A list of recommendations

generated from the day has led to

the development of an initiative

called New Ambulatory Models of

Care (NAMoC).

NAMoC, a joint initiative undertak-

en by CCO’s Models of Care and

Oncology Nursing Programs, fo-

cuses on 3 key recommendations:

Identifying and evaluating

nurse-led models in active

treatment (clinical service that

is run or managed by

registered nurses);

Supporting the development of

a uniform role description for

oncology nurses; and

Promoting 24/7 access to care

for urgent needs and symptom

management support.

The goal of the NAMoC Initiative

is to partner with CCO’s Planning

and Regional Programs along with

the regional cancer centres to

identify, evaluate, and spread

innovative ambulatory models of

care that optimize the scope of

practice of oncology nurses within

the interdisciplinary team. Over

the coming months, a Steering

Committee will provide oversight

and direction on how best to im-

plement these recommendations.

For more information about this

initiative, please contact Dora

Yuen, Project Coordinator at:

Dora.Yuen@cancercare.on.ca