Melanoma Management in Western Australia

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Wendy Kelly
10 years ago
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1 Melanoma Management in Western Australia The changing face of the MDT Dr Mark Hanikeri MBBS, FRACS Specialist Plastic Surgeon Director of the Western Australian Melanoma Advisory Service

2 Current Situation-WAMAS Only dedicated Melanoma MDT for WA Indication for referral- BT> 1 mm, Metastatic disease See about 120 patients/year (Treatment not complete) Discuss a further patients/year (Treatment complete) Public and Private Patients

3 Current Situation-WAMAS WAMAS is based at SJOGHS Jointly funded by WA Health Department and SJOGHS No Research Lead or Clinical Lead PT Clinical Director, PT Nurse coordinator, PT Nurse and PT Administration assistant WAMAS meets monthly (First Monday evening) Around 30 Specialists in Clinical Committee (Surgeons, Dermatologists, Oncologists, Pathologists, Nuclear Physicians) Nursing and Administration staff Discuss around 20 patients referred that month (8-12 actually seen) All pathology is reviewed by WAMAS pathologists and discussed Small Panel Meetings (Surgeon, Dermatologists, Pathologist, Oncologist). Usually see 4-5 patients per clinic- No distinction between public/private

4 Current Situation-WAMAS Provides written advice and feedback to referring doctor +/- arrange investigations and treatment if asked to do so. No teleconference facility No Fellows, Registrars involved in the service Education evenings, Information Booklet, Phone advice to clinicians Clinical research/retrospective reviews initiated and supervised by Director and other clinicians as required Data input/ Database maintained by nurse coordinator and administration assistant

5 The Kirkbride Melanoma Centre KMC

6 Proposed Unit-KMC Based at Harry Perkins Institute of Medical research (Formerly WAIMR) Jointly funded (WA Health dept, SJOGHS, KMC?) Modelled on MIA- Hub and Spoke Model of care HT Clinical Lead (For recruitment), HT Research Lead (For recruitment), FT nurse coordinator, FT Clinical Nurse, FT admin assistant +/- FT/PT database manager MDT- Clinicians as per WAMAS but broadened scope

7 Proposed Unit-KMC Will initially relocate to Harry Perkins Institute for Medical Research- First half 2016 Change to model of patient review- No longer personal consultations by MDT. Public and Private Patients Will increase Consultant numbers Patients will be reviewed by Consultants on 1:1 basis (Rooms or clinics) and presented to MDT as needed based on pathology Plan to Broaden scope of referrals- Eventually ALL Melanomas would be suitable for referral in an Opt in basis Will phase in treatment protocols and take over management if asked to by referring clinicians

8 Proposed Unit-KMC What s different?? Clinical chair and Research chair Increased staffing- Consultant, Nurse, Admin, Data entry Structured research initiated and supervised Hub and Spoke rather than centralised model favours teleconferencing and regional spokes Capacity to recruit and treat patients under KMC umbrella Opportunity for Centre of Excellence in WA Opportunity to assess results via database and clinical audit

9 Proposed Unit-KMC What s needed?? Funding- DoH, SJOGHS, HPIMR/KMC Migration of WAMAS database into KMC database Migration of WAMAS to HPIMR Recruitment of Specialists into Hub and Spoke model Engagement of clinicians treating melanoma- urban and rural Recruitment of Clinical chair and Research chair Broadening of referral base- Eventually any melanoma Recruitment of Staff-Nurse, Admin, Data entry Establishment of teleconference facilities at regional spokes Establishment of new clinic and audit protocols

10 Transitioning WAMAS to the Kirkbride Melanoma Centre WAMAS Current Staffing (1.6FTE) P/T Admin Assistant P/T Nurse Coordinator Medical Oncologist WAMAS Kirkbride Melanoma Centre Clinical Chair Nurse Coordinator Admin Assistant Biospecimen Coordinator Multidisciplinary Team (MDT) P/T Clinical Nurse Clinical Nurse Kirkbride Future Additional Staffing Academic Chair Database/IT Manager StJOG Source of Referrals

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