NEMICS Program Manager Kathy Simons has moved to a new position in mental health at the Austin. Kathy, along with NEMICS Director A/P Paul Mitchell and former NEMICS team members Carmel Vermeltfoort and Mandy Byrne, developed the first iteration of the Victorian Tumour Summits project as a pilot in 2014.
Kathy and Mandy reflect here on the origins of the project and how it has evolved.
‘We had, in the very early days of the ICS, local tumour groups that were really designed to do locally what the summits are now doing statewide. We plugged away with those for a number of years but without much traction,’ says Kathy.
‘So, we knew that when we were able to provide data we got quite good clinician engagement. Paul Mitchell [NEMICS Clinical Director] said, “You know, I don’t think that most doctors know just exactly what they can get from administrative data.”
Paul was aware of the success of the work of the National Cancer Inetelligence Network in the UK. It was thinking about that and going, “Well, rather than doing it the way they were doing it [overseas], maybe we could just see if we could get the leaders over the line around the data and what was possible and then spread it out. We had no idea what that would deliver. But we thought we could probably get clinicians to the table with the data and possibly keep them at the table with data. That’s sort of how we went about it. We originally “sold” the idea to the other ICS and the DoH, and finally it was accepted as a proof-of-concept idea –“Well, we'll give it a whirl and see what happens.”’
Mandy concurs. ‘Paul always had a focus on getting data to the clinicians in a way that made sense to them. When clinicians used to get VAED reports, they were frustrated because they always felt it didn't really reflect the volume of work and [that] there were issues with the coding. Our primary aim was getting information in a way that clinicians want to use it. Paul, Kathy, Carmel and I spent a lot of time looking at how could we present the data in a meaningful manner to inspire clinicians to ask further questions and create a dialogue, so that the data then takes them on a journey through exploring.’
Kathy remembers the first summit. ‘Honestly, at the time, we had no idea what it would actually deliver. Colorectal, which was the first one, delivered something like 13 recommendations. And those recommendations were an amazing mix of really detailed, specific clinical things like how many lymph nodes were being collected at surgery right through to, “you need some way of ensuring that all cancer MDMs are the same” – a quality framework. We also unpacked across those first couple of summits that there was a real gap between the clinicians’ understanding of their ability to improve services, which they could do independently, and ICS-led work in that space, and so it was also a forum bringing the ICS-led and clinically-led service improvement models together.’
Mandy recalls working on the first colorectal summit.
‘‘It really was a ground-up thing and I think that's why the model made sense. The philosophy of the ICS was to get that localised input from clinicians to the DH, rather than a top-down approach. The ICS were acting as ‘clinician advocates’, so to speak. Carmel and I were experimenting a lot with, “How do we present it, what do we do? How do clinicians want to see the data?” We were trying some really different things at that time. It probably looks pretty tame now but at the time it wasn't. Kathy had the big picture, Carmel had the quality framework focus, I explored the data, and the three of us came up with quite a structured approach to it."
Mandy adds, ‘Peter Briggs and Brian Hodgkinson were very helpful for the first summit. I think it was having a chair in the area, that leading clinician representative in there, that helped drive that the data came from clinicians and not from us as data people. That helped gain the acceptance of other clinicians – knowing an actual clinician had reviewed it, presenting the data so that clinicians had confidence in what they were hearing.’
Mandy concludes, ‘I think Kathy has such a good big picture view and they are lucky to have her in her new role – she’ll do good things. She can see the question and she can translate it into what you’re trying to get out of it and guide you through.’
‘I’d have to thank the clinical directors at the time,’ says Kathy. ‘Paul Mitchell, Jeff Szer and Peter Grant. On a leap of faith, they just went out there to their respective ICS people to spruik it as an idea without any tangible example at the time to do something with it. Clinician engagement is one thing – clinician leadership is the next step.’