Creating Innovation in Cancer Care Delivery

Creativity and innovation are words in common use when discussing the challenges facing cancer care delivery. Creativity in cancer care yields almost 3 million hits on Google, while innovation in cancer care yields almost 6 million. For peer‐reviewed papers, the figures in Google Scholar are 87,000 and 460,000, respectively. For nurses working on the frontline of cancer care, the challenge is to work through this mass of information to consider how best to approach redesigning the delivery of care to get best outcomes for patients and make best use of the skilled workforce. The imperatives for innovation and creativity in health care generally and cancer care specifically are many. First, there is the aging of the population with vast numbers of people experiencing chronic disease and placing strain on already stretched services. In the context of cancer, aging is a critical issue because cancer is largely a disease of aging and as the population over 65 grows so too does the incidence of cancer. Second, evidence is growing faster than our capacity to adapt, so we need help to filter and synthesize evidence to pull out that which is relevant to the problem we are trying to address. Third, models of care are changing. Hospitals are increasingly only for those patients with acute care needs with more and more care expected to be delivered in the home and ambulatory setting. This is very much true for cancer treatment, and Asian nurses will see the same kinds of shifts that have occurred in the USA, UK, and Australia, with almost all chemotherapy and radiotherapy delivered in day treatment centers and an increasing proportion of patients having day‐only surgery. This challenges how we prepare patients for treatment and increases the emphasis we need to place on preparing the patients and family members for self‐management, particularly of treatment side effects, in the home. Fourth, technology has huge potential to shape the models of care that develop, but to date, nurses have been largely passive recipients of technological innovation. To do this nurses need skills in designing and using technology and care systems that are patient centered and enhance rather than impede the delivery of nursing care. Fifth, we face a global health workforce shortage and will be required to redesign how nurses work. Models of care and technological innovation will be at the center of rethinking how we make our workforce support larger numbers of patients with increasingly complex needs. One model worthy of consideration by nurses seeking to influence practice and support changes to models of care is that developed by Kitson et al. called the Promoting Action on Research Implementation in Health Services (PARIHS Sanchia Aranda1,2 1Cancer Council Australia, 2School of Health Sciences, University of Melbourne, Melbourne, Victoria, Australia