6.5.1 Tertiary Partners’ Role in Provincial Pediatric Oncology Satellite Program

Responsibilities of the tertiary partner to its satellite partner include:

1. Timely, ongoing education by team members and clinical consultation.
2. The timely transfer of necessary patient/family information, as specified in this document including a copy of the treatment schema at the time of referral and ongoing components of the roadmap or treatment plan as appropriate.
3. The documented review of, and feedback on, the satellite’s annual activities – to the satellite and to POGO.

Where more than one tertiary program works in partnership with a specified satellite, the tertiary-level educational responsibilities for that satellite may be divided according to mutual preference.

Agreements
The pediatric oncology satellite program requires the following formal agreements:

1. An affiliation agreement signed by each tertiary hospital and each formal satellite partner with POGO, declaring commitment to participate fully in the provincial pediatric oncology care of eligible patients, in accordance with the roles and responsibilities developed collaboratively and set down in this document.

By virtue of entering into the Provincial Pediatric Oncology Satellite Program partnership with POGO and with identified satellite partners, it will be understood that:

1. Involved tertiary staff will be made fully aware of all program requirements, including the appropriate accrual and management of patients, care, consultation, communication and documentation that will result.
2. Designated physicians, nurses and allied health will participate in the review and update of standards and guidelines on a regular basis, so that satellite care for children with cancer may continue to have a provincial standard.
3. Educational, consultation and other responsibilities of the tertiary staff, as outlined throughout this document, will be honoured.
4. Infrastructure and formal requirements for the provision of a well integrated program will be met, including: facilitation of any special hospital policies needed; development of agreements with organizations/services/care providers external to the hospital; and provision of adequate secretarial, administrative and technical arrangements to ensure the timely flow of clinical information between the satellite and tertiary partners.
5. The hospitals that house those pediatric oncology specialty programs participating in the pediatric oncology satellite program will support those programs in their collaboration with satellite partners.
6. Participation in program evaluation will occur (see Participation in the Evaluation of the Model of Service Delivery section below).
7. Timely accounting will be made of services provided and of the funding allocation flowed by the Ministry of Health and Long Term Care via POGO

Tertiary Staffing Participants
Tertiary staffing participants include:

1. Outreach Program Coordinators in each tertiary center responsible for the coordination of the pediatric oncology outreach program as well as the identification of individuals (typically nurses) responsible for case coordination and for consultation and teaching of satellite partners.
2. Physician Oversight: Each tertiary centre shall designate a responsible physician to act as the primary liaison and champion of satellite care.
3. Allied Health Team Ensure continued availability of the Child Life Specialist, Social Worker, Nurse, Psychologist, Pharmacist, Dietitian, Hospital Teacher, and other health care professionals to assess patient/family needs and to develop allied health treatment plans for all patients.

 Tertiary Hospital and Pediatric Oncology Program Commitment
The tertiary hospital and pediatric oncology program commitment is as follows:

1. To ensure ongoing participation in education, consultation, and mentoring to support satellite staff including: the designation of a nurse (case) coordinator for every case to be managed with satellite collaboration, and ready availability by telephone of that nurse/a designate on the in-patient unit for consultation and; ready telephone access of satellite staff to the treating (tertiary-based) oncologist/designate for consultation as needed.
2. To ensure that all relevant clinical information is transferred as part of referral to satellite care at least 24 hours prior to the first satellite visit
3. To provide timely updates of patient progress, including any alterations in treatment plan and management.
4. To participate in the review and update of standards and guidelines in collaboration with other partners in the provincial satellite program.

Clinical Communication, Data Transfer and Technological Support

1. To convey to satellite partners all information relevant to the child’s medical/ nursing care, both initially via the Initial Data Transfer Sheet, physician referral note, and other appropriate documentation via secure channels (fax, shuttle sheet, etc.).
2. Communication of key aspects of the allied health treatment plan to satellite partners, both initially and when these treatment plans are periodically updated (Communication Formats). Release of this data will be subject to appropriate consent signed by a parent/guardian, where applicable.
3. To ensure the completeness of the child’s electronic record for the purposes of tertiary health care charts, clinical trials, POGONIS and other data exchange agreements.

Participation in the Evaluation of the Model of Service Delivery
The scope and specific requirements of the evaluation of this pilot program will be communicated to all partners upon completion of the research design. Full participation in this evaluation will be essential.