Establishing a community infusion service in Canterbury, New Zealand: strategies and lessons
Background and context An increasing number of drugs and blood products need to be delivered by intravenous infusion. In the Canterbury region of New Zealand, these have historically been delivered at a hospital site; however, some infusions could be delivered in a community setting without comprom...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
CSIRO Publishing
2022-01-01
|
| Series: | Journal of Primary Health Care |
| Subjects: | |
| Online Access: | https://www.publish.csiro.au/hc/pdf/HC21103 |
| _version_ | 1828114431415943168 |
|---|---|
| author | Graham McGeoch Brett Shand Lisa McGonigle |
| author_facet | Graham McGeoch Brett Shand Lisa McGonigle |
| author_sort | Graham McGeoch |
| collection | DOAJ |
| description |
Background and context
An increasing number of drugs and blood products need to be delivered by intravenous infusion. In the Canterbury region of New Zealand, these have historically been delivered at a hospital site; however, some infusions could be delivered in a community setting without compromising patient safety.
Assessment of problem
The Canterbury health system has a key strategic objective of delivering care close to patients’ homes. In 2018, Canterbury district health board (DHB) put out a tender for a community infusion service that would deliver blood products and other intravenous drugs with appropriate medical oversight.
Strategies for improvement
Following an interview and selection process, a fee-for-service contract was developed with a group of general practices with partial common ownership. It was nurse-led with medical oversight available. In July 2018, a Community Infusion Service (CIS) was started in two urban sites in Canterbury. It later expanded to two more sites, one urban and one rural.
Results
From July 2018 to May 2021, over 3000 infusions and blood transfusions were delivered by the CIS across seven infusion types (blood; immunoglobulin; infliximab; natalizumab; pamidronate; toculizumab; zoledronic acid). Both general practice and hospital services referred patients to the CIS. No major incidents were reported. Patients reported satisfaction with the service.
Lessons
Infusions and blood products can be delivered safely nearer to patients’ homes in primary care in a New Zealand setting. Medical input was rarely required; however, the transition was resource-intensive; it required both overall process and criteria negotiations, as well as individual patient discussions. In its initial stages, the CIS did not have adequate clinical governance and operational support, which affected the speed and scale of its development.
|
| first_indexed | 2024-04-11T12:24:20Z |
| format | Article |
| id | doaj.art-0f39a4a11f834f9dbc6166c09c070d7c |
| institution | Directory Open Access Journal |
| issn | 1172-6156 |
| language | English |
| last_indexed | 2024-04-11T12:24:20Z |
| publishDate | 2022-01-01 |
| publisher | CSIRO Publishing |
| record_format | Article |
| series | Journal of Primary Health Care |
| spelling | doaj.art-0f39a4a11f834f9dbc6166c09c070d7c2022-12-22T04:23:59ZengCSIRO PublishingJournal of Primary Health Care1172-61562022-01-01142151155HC21103Establishing a community infusion service in Canterbury, New Zealand: strategies and lessonsGraham McGeoch0Brett Shand1Lisa McGonigle2Canterbury Initiative, Canterbury DHB, 32 Oxford Terrace, Christchurch 8011, New Zealand.Canterbury Initiative, Canterbury DHB, 32 Oxford Terrace, Christchurch 8011, New Zealand.Canterbury Initiative, Canterbury DHB, 32 Oxford Terrace, Christchurch 8011, New Zealand. Background and context An increasing number of drugs and blood products need to be delivered by intravenous infusion. In the Canterbury region of New Zealand, these have historically been delivered at a hospital site; however, some infusions could be delivered in a community setting without compromising patient safety. Assessment of problem The Canterbury health system has a key strategic objective of delivering care close to patients’ homes. In 2018, Canterbury district health board (DHB) put out a tender for a community infusion service that would deliver blood products and other intravenous drugs with appropriate medical oversight. Strategies for improvement Following an interview and selection process, a fee-for-service contract was developed with a group of general practices with partial common ownership. It was nurse-led with medical oversight available. In July 2018, a Community Infusion Service (CIS) was started in two urban sites in Canterbury. It later expanded to two more sites, one urban and one rural. Results From July 2018 to May 2021, over 3000 infusions and blood transfusions were delivered by the CIS across seven infusion types (blood; immunoglobulin; infliximab; natalizumab; pamidronate; toculizumab; zoledronic acid). Both general practice and hospital services referred patients to the CIS. No major incidents were reported. Patients reported satisfaction with the service. Lessons Infusions and blood products can be delivered safely nearer to patients’ homes in primary care in a New Zealand setting. Medical input was rarely required; however, the transition was resource-intensive; it required both overall process and criteria negotiations, as well as individual patient discussions. In its initial stages, the CIS did not have adequate clinical governance and operational support, which affected the speed and scale of its development. https://www.publish.csiro.au/hc/pdf/HC21103blood transfusionscommunitycontractinggovernance,health system changeimmunoglobulininfusions |
| spellingShingle | Graham McGeoch Brett Shand Lisa McGonigle Establishing a community infusion service in Canterbury, New Zealand: strategies and lessons Journal of Primary Health Care blood transfusions community contracting governance,health system change immunoglobulin infusions |
| title | Establishing a community infusion service in Canterbury, New Zealand: strategies and lessons |
| title_full | Establishing a community infusion service in Canterbury, New Zealand: strategies and lessons |
| title_fullStr | Establishing a community infusion service in Canterbury, New Zealand: strategies and lessons |
| title_full_unstemmed | Establishing a community infusion service in Canterbury, New Zealand: strategies and lessons |
| title_short | Establishing a community infusion service in Canterbury, New Zealand: strategies and lessons |
| title_sort | establishing a community infusion service in canterbury new zealand strategies and lessons |
| topic | blood transfusions community contracting governance,health system change immunoglobulin infusions |
| url | https://www.publish.csiro.au/hc/pdf/HC21103 |
| work_keys_str_mv | AT grahammcgeoch establishingacommunityinfusionserviceincanterburynewzealandstrategiesandlessons AT brettshand establishingacommunityinfusionserviceincanterburynewzealandstrategiesandlessons AT lisamcgonigle establishingacommunityinfusionserviceincanterburynewzealandstrategiesandlessons |