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POGO Satellite Manual

6.0 POGO Satellite Program Administration Documents

6.1 Goals and Objectives

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The ongoing development, formalization and maintenance of POGO Satellite Clinics as part of the provincial pediatric oncology network is an important component of a coordinated and graduated service delivery system, which will optimize the use of appropriate resources and expertise available at the community, POGO Satellite Program and specialized childhood cancer program levels.

The central goals and objectives of the POGO Provincial Pediatric Oncology Satellite Program are to:

  • Permit childhood cancer patients to receive components of their care and treatment in designated community hospitals closer to their homes, according to defined, acceptable standards of care.
  • Ensure that satellite care is equivalent to specialized childhood cancer program care – i.e., that it is medically equivalent, pediatric, family-centered, humanistic and supportive, resulting in equivalent treatment and outcomes, including enabling the continued participation of children in clinical trials – thereby realizing the significant advantages of protocol-driven, outcome-evaluated treatment.
  • Ensure that specialized childhood cancer program/POGO Satellite Clinic collaboration constitutes a designated part of the formal system of pediatric oncology care, through the:
    • Utilization of specified, formally prepared community hospital staff to deliver components of care. Formal preparation seeks to develop a level of knowledge and familiarity with the care of children with malignant disease and the support of their families.
    • Assurance that care, documentation, treatment policies and practices reflect best practices in the POGO Satellite Program, conforming to defined yet generic standards while allowing for differences among POGO Satellite Clinics.
    • Identification of components of therapy and patient management that may be delivered in the POGO Satellite Clinic context and the optimization of standards of practice through the introduction of guidance documents for care, including management of infection, fever and neutropenia, antiemetics, cytokines, transfusion, Insuflon™ use, immunization, etc.
    • Designation of a program coordinator in each participating specialized childhood cancer program and POGO Satellite Clinic, who will monitor and facilitate implementation of all aspects of formal pediatric oncology activity, according to standards and guidance documents.
    • Assignment of a case coordinator in the participating specialized childhood cancer program for each patient/family, who will monitor and integrate the care at all levels to ensure optimal access to tertiary, quaternary, community and home-based resources, for both medical and supportive care.
    • Creation of a strategic alliance between specialized childhood cancer programs and community pediatric programs, whereby a joint program for total care of childhood cancer patients is developed to meet the needs of the children. To this end, there should be:
      • Defined governance, responsibility and accountability of the partners and their associated institutions.
      • Close integration of POGO Satellite Clinic healthcare professionals into the staffing team and treatment plans developed for the child at the principal (diagnosing) specialized childhood cancer program, with resulting advantages for coherent, coordinated service delivery.
    • Development of effective, optimally electronic communication tools to ensure consistent and comprehensive data sharing and communication between POGO Satellite Clinics and specialized childhood cancer programs
  • Address the significant disruption of families, through the:
    • Reduction of out-of-pocket expenses and economic stress on families (including familial disruption, loss of income).[1]
    • Reduction of lengthy absences from home, for care in specialized childhood cancer programs, over the chronic course of illness and treatment.
    • Decreased school absences resulting from care in specialized childhood cancer programs distant from home, over the chronic course of illness and treatment.
  • Achieve cost containment within the healthcare system and optimal use of scarce, existing resources through:
    • Rational redistribution of service delivery to loci of care that may be less costly. POGO will continue, through the monitoring and evaluation of new forms of program delivery, to seek this objective.
    • Alleviation of understaffing and the improvement of access by patients to their caregivers in specialized childhood cancer program and community service delivery levels.
    • Operation according to provincial practice guidance documents.
  • Ensure continued comprehensive data for policy development and service planning, including comprehensive service records on all patients, so that exact information about treatment and outcome, service demand and cost and quality analyses of the highest order will continue to be possible.
Disclaimer: Source Accuracy

You are welcome to download and save a local copy of this document in the Word and/or PDF formats provided. As the POGO Satellite Manual is subject to ongoing revisions and updates by POGO, we recommend you regularly check the online version posted at https://www.pogo.ca/satellite-manual/ to ensure you have the most up-to-date content. In the event of any inconsistency between the content of a local copy and the online version of the POGO Satellite Manual, the content of the online version shall be considered correct. Please see also the POGO Satellite Manual Disclaimer.

Record of Updates
Version NumberDate of EffectSummary of Revisions
17/2/2021Original version posted.

[1] Barr, RD, Furlong, W, Horsman, JR, Feeny, D, Torrance, GW, and Weitzman, S. The monetary costs of childhood cancer to the families of patients. International Journal of Oncology 1996; 8: 933–940.

6.2 Participant Site Selection
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In this Section

  • 1.1 History and Overview
  • 1.2 Acknowledgements
  • 1.3 Committees and Working Groups
  • 1.4 POGO Satellite Manual Disclaimer
  • 2.1 Principles of POGO Satellite Clinic Care
    • 2.1.1 POGO Satellite Care Decision Flowchart
  • 2.2 Eligible Patients
    • 2.2.1 Children Eligible for Chemotherapy Administration in a POGO Satellite Clinic
    • 2.2.2 Children Eligible for the Management of Complications in a POGO Satellite Clinic
    • 2.2.3 Children Eligible for Supportive Care in a POGO Satellite Clinic
  • 2.3 Scope of POGO Satellite Clinic Practice
  • 2.4 Expanded POGO Satellite Clinic Practice
  • 3.1 Safe Handling, Administration and Disposal of Chemotherapy Agents
    • 3.1.1 Personal Protective Equipment
    • 3.1.2 Preparation, Transport and Storage
    • 3.1.3 Administration of IV Hazardous Drugs
    • 3.1.4 Administration of Oral Hazardous Drugs
    • 3.1.5 Disposal of Equipment/Personal Protective Equipment used to Administer Hazardous Drugs
    • 3.1.6 Safe Handling for Pharmacy
    • 3.1.7 References
  • 3.2 Accidental Exposure/Spills
  • 3.3 Extravasation Management
    • 3.3.1 Prevention and Management of Extravasations
    • 3.3.2 Antidotes and Treatments for Extravasation
    • 3.3.3 Sample Extravasation Documenting Tool
    • 3.3.4 References
  • 3.4 Injecting SC Medication Via an Insuflon
  • 3.5 Chemotherapy Administration Reference List
  • 3.6 Central Venous Catheter Care
  • 3.7 Chemotherapy Quick Reference
    • 3.7.1 Rapid Hydration
    • 3.7.2 Provider Guide: Prevention and Management of Irinotecan-Induced Diarrhea
    • 3.7.3 Capizzi Methotrexate
    • 3.7.4 Erwinia Asparaginase
    • 3.7.5 Crisantaspase (Rylaze) Asparaginase
    • 3.7.6 Nelarabine
  • 4.1 Management of Fever and Neutropenia
    • 4.1.1 Routine Order Sample Sheet
    • 4.1.2 Sample Fever Cards
    • 4.1.3 Outpatient Fever and Neutropenia in POGO Satellites
  • 4.2 Pentamidine Administration
    • 4.2.1 Inhaled Pentamidine
    • 4.2.2 Intravenous Pentamidine
  • 4.3 Antiemetics
  • 4.4 Treatment of Varicella-Zoster Infections
  • 4.5 Immunization of Children with Cancer
  • 4.6 Transfusion
  • 4.7 Clinical Circumstances that Warrant Consultation with the Specialized Childhood Cancer Program
  • 5.1 Palliative Care Overview
  • 5.2 Communication
  • 5.3 Settings of Care
  • 5.4 Symptom Management
  • 5.5 End of Life
  • 5.6 When a Child Dies at the POGO Satellite Clinic
  • 5.7 Appendix: Sample Bereavement Materials
    • 5.7.1 Reconciling Your Grief
    • 5.7.2 Funeral Arrangement Checklist
    • 5.7.3 Helping Children Who Grieve
    • 5.7.4 Coping with the Holidays
    • 5.7.5 The Grief Experience
  • 5.8 References
  • 6.1 Goals and Objectives
  • 6.2 Participant Site Selection
    • 6.2.1 Tertiary Hospital Site Selection
    • 6.2.2 Community Hospital Site Selection
  • 6.3 POGO’s Roles
    • 6.3.1 PHIPA, Privacy and Research
  • 6.4 Funding
    • 6.4.1 Funding Support for Tertiary Hospital Activity
    • 6.4.2 Funding Support for Community Hospital Activity
  • 6.5 Infrastructure and Formal Requirements
    • 6.5.1 Specialized Childhood Cancer Program Partners’ Role in the POGO Satellite Program
    • 6.5.2 POGO Satellite Clinic Partners’ Role in the POGO Satellite Program
  • 7.1 Preamble
  • 7.2 Investigator Responsibilities
  • 7.3 Training Requirements
    • 7.3.1 General Training for Conduct of Research
    • 7.3.2 Protocol-Specific Training
  • 7.4 Research Activities That May Be Completed in POGO Satellite Clinics Under Supervision of DSI
  • 7.5 Research Activities to be Completed in Specialized Childhood Cancer Programs Only
  • 7.6 Recognition and Reporting of Adverse Events (AEs)
  • 7.7 Data Transfer
  • 7.8 Pharmacy Drug Accountability
  • 7.9 Site Inspections and Quality Assurance
  • 8.1 Pediatric Oncology Shared Care Initial Data Transfer Sheet
  • 9.1 POGO Satellite Clinic Preparedness Checklist
  • 9.2 POGO Satellite Clinic Quality Assurance Checklist
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