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Communities Oncology Network

The BC Cancer Agency, an agency of the Provincial Health Services Authority provides a province-wide, population-based cancer control program for the residents of BC and the Yukon.
About

PHSA is one of six health authorities – the other five health authorities serve geographic regions of B.C. PHSA's primary role is to ensure that B.C. residents have access to a coordinated network of high-quality specialized health care services. 

 

The Communities Oncology Network is a collaborative voluntary partnership with hospitals in the health authorities in conjunction with BCCA Cancer Centres and the Systemic and Radiation Programs.

Components of the Communities Oncology Network include patients and their families, community health care providers and volunteers, hospitals, community groups, Health Regions, the BC Cancer Agency Regional Centres and all the processes facilitated by the Agency. The components are interdependent and held together by trust, mutual respect, communication and education.

Due to issues of geographic distance and oncologist shortage patients may be seen by a medical oncologist, from one of the six Regional Cancer Centres, via a video-consult. The oncologist will formulate a management plan and transfer care to a General Practitioner in Oncology (GPO) or internist through a formalized process (CON Referral) who will oversee and assume responsibility of delivery of chemotherapy and medical care in the patient's local community at a recognized Community Oncology Centre with ongoing reporting to and supervision from the MRP and/or other BCCA oncologists. The BCCA has ensured that the GPO’s and/or internists have the necessary ability, knowledge, and skill to manage the care of these patients. The BCCA and the respective Health Authorities work together to ensure that the community cancer centres meets the BCCA standards as defined by the CON model. These standards outlining infrastructure and processes necessary for a comprehensive community cancer care program are found at the BCCA website.

Evidence supports the observation that patient outcomes from their cancer treatment are related to the experience of their care providers. Quality care for cancer patients requires a dedicated team of health care professionals knowledgeable about all aspects of cancer care, working together to deliver that care.

The CON facilities must have at a minimum, appropriately trained and competent staff (nurses, physicians, pharmacists) to administer and manage the cytotoxic and hazardous products used to treat cancer. As well they must have access to clinical diagnostic services, such as haematology, with the capability to provide all of the information required to monitor cancer therapy. Additionally these communities must have the capabilities to respond to complications of therapy 24 hours per day.

Each of the community health care professionals must be supported to develop and maintain their competency.


Physician: The medical staff within the health care community ought to identify one or two physicians who have an interest in cancer care and chemotherapy delivery and are willing to obtain oncology expertise through the Family practice oncology Network preceptorship program or other similar experience. Maintenance of competency would be by yearly updates such as at a Regional Cancer Centre, the BCCA Annual Cancer Conference or other means.


Registered Nurses: The appropriate health care leader(s) within the community ought to identify nurses who have an interest in oncology nursing and are willing to obtain chemotherapy certification at the BCCA, or other similar training program in a regional Health Authority. Each chemotherapy certified nurse is responsible for maintaining continuing competency in the care of patients receiving chemotherapy and will demonstrate this annually by:

  • Recording administration of at least 50 chemotherapy drugs per year.
  • Recording participation in at least 10 hours of continuing education annually that is specifically related to care of patients receiving chemotherapy.

The nursing leadership supports the nurse in meeting requirements for continuing competency by facilitating scheduling and education relief time.

Information about chemotherapy certification education for nurses, including course outline, expectations for continuing competency, nurse selection, and application process is available in Chemotherapy Nursing


Pharmacy Staff: The appropriate health care leaders within the community ought to identify one or two pharmacists who have an interest in oncology pharmacy care and are willing to expand their knowledge of oncology care. This knowledge can be obtained in different ways such as liaising with pharmacy staff from the BCCA, participating in professional development opportunities provided by the BCCA, and the Pharmacy Professional Meeting at the BCCA Annual Cancer Conference. In addition, pharmacy technicians trained in the safe handling and preparation of cytotoxics and hazardous drugs should be supported to maintain their expertise and competency.

BCCA medical oncologists will not be referring patients to communities that do not meet the foregoing standards.

 

The hospitals offering chemotherapy services across the province have been divided into four broad categories. The level definitions and descriptions are as follows:


Satellite Centres of the BC Cancer Agency: Level IV

A Satellite Centre is staffed by a BC Cancer Agency (BCCA) medical oncologist, and/or a BCCA General Practitioner receiving remote support from a BCCA regional centre.

The Centre also has chemotherapy certified oncology nurses, oncology trained pharmacists and pharmacy staff. All chemotherapy in these centres is supervised by a BCCA medical oncologist. 

Satellite Centres prepare and deliver oral and parenteral outpatient chemotherapy agents. This includes first dose treatment and the full spectrum of outpatient chemotherapy protocols as delineated by the BC Cancer Agency. Please contact individual sites to determine ability to administer specific in-patient chemotherapy regimens.

It is also electronically connected to the BC Cancer Agency’s Cancer Agency Information System (CAIS) and therefore has full access to electronic patient information.

The service is available from Monday to Friday. 


Full-Service Community
Chemotherapy Centres: Level III

A Full Service Community Chemotherapy Centre is located in a general community hospital and delivers out patient oral and parenteral cancer chemotherapy as well as provides medical and nursing support for cancer patients. The Centre is typically staffed with community physicians who are general oncologists, internists, general practitioners and/or General Practitioners in Oncology (GPO), graduates of the BC Cancer Agency's Family Practice Oncology Network Preceptorship Program, chemotherapy certified oncology nurses, oncology experienced pharmacists and pharmacy staff. Referring physicians are required to complete a Communities Oncology Network referral for the transfer of care.


Staff is able to manage all types of out patient IV and oral chemotherapy protocols including first cycle and trained in care and management of central venous access devices.

Staff does not have access to the BC Cancer Agency’s Cancer Agency Information System (CAIS) unless specifically indicated.

The service is available from Monday to Friday.


Basic Community Chemotherapy Service: Level II

Chemotherapy services offered are limited with restrictions to types of chemotherapy treatments, specialized equipment or specialized skill. A basic community chemotherapy service typically consists of at least a chemotherapy certified oncology nurse. One or more physicians maybe involved in the medical management of patients on chemotherapy. It may not be advisable to do first cycle in these centres depending on the expertise available and the particular chemotherapy regimen.

Staff does not have access to the BC Cancer Agency’s Cancer Agency Information System (CAIS) unless specifically indicated.

Please contact specific location health care professional for days and hours of service.


Community Chemotherapy Service: Level I

Minimal amount of oncology service offered. Nature of services varies from site to site. These hospital pharmacies dispense some anticancer drugs. No formalized cancer care team available. BC Cancer Agency does not recommend intravenous chemotherapy to be provided by these facilities.

Staff does not have access to the BC Cancer Agency’s Cancer Agency Information System (CAIS) unless specifically indicated.

Please contact specific location health care professional for days and hours of service.


Documents, Forms, Statistics
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SOURCE: Communities Oncology Network ( )
Page printed: . Unofficial document if printed. Please refer to SOURCE for latest information.

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