Designing and implementing a bundle of care for patients with early-stage breast cancer: lessons from a pilot program

Yvonne Zissiadis; Helen Ballal; Nicola Forsyth; Angela Ives; Lee Jackson; Anna Montgomery; Sarah Wise; Wen Chan Yeow; Christobel Saunders

doi:10.1071/AH24009

RESEARCH ARTICLE (Open Access)

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Designing and implementing a bundle of care for patients with early-stage breast cancer: lessons from a pilot program

Yvonne Zissiadis ^A , Helen Ballal ^B , Nicola Forsyth ^A , Angela Ives

^C , Lee Jackson ^B , Anna Montgomery ^D ^* , Sarah Wise

^E , Wen Chan Yeow ^B and Christobel Saunders

^F

+ Author Affiliations

- Author Affiliations

^A GenesisCare, Perth, WA, Australia.

^B St John of God Healthcare, Perth, WA, Australia.

^C Medical School, University of Western Australia, WA, Australia.

^D GenesisCare, Alexandria, NSW, Australia.

^E School of Public Health, University of Technology Sydney, NSW, Australia.

^F Melbourne Medical School, University of Melbourne, Vic., Australia.

^* Correspondence to: anna.montgomery@genesiscare.com

Australian Health Review 48(2) 142-147 https://doi.org/10.1071/AH24009

Submitted: 11 January 2024 Accepted: 6 March 2024 Published: 3 April 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

We present a case study on the design and implementation of a value-based bundled package of care for patients with early-stage breast cancer treated in the private health sector in Australia. Value-based healthcare is an essential change to how we deliver healthcare, shifting the focus from paying for individual services provided to a focus on the health outcomes gained over a full cycle of care. The Australian health system has unintentionally created barriers to value-based cancer care through fragmented care pathways and complex funding arrangements where patients can unexpectedly encounter high out-of-pocket costs. A team of clinicians, service providers, health systems and funding experts, private health insurers and consumers have collaborated to design and pilot a complete bundled package of care for breast cancer patients which aims to address these challenges. With 40 patients recruited to date, early evaluation results show positive patient experience of ‘joined-up’ care and financial transparency. This case study provides a high-level overview of the approach taken to design and implement the Breast Cancer Bundle and the lessons learned for its expansion in both public and private settings.

Keywords: breast cancer care pathway, bundle of care, coordinated care, patient experience, patient navigation, value-based models of care.

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