Improving the dietetic referral pathway for patients with cancer in the outpatient session: Project evaluation

Miss Karman Liu1, Mrs Jenna Riley1, Ms Karen Edis1, Ms  Fiona Turnbull1

1Peninsula Health, Melbourne, Australia

Aim: ‘Improving the dietetic referral pathway for Outpatients with cancer’ was implemented in 2012. This evaluation considers the impact of the pathway on referral and attendance rates, referral source and the ability to identify patients with malnutrition.

Methods: A retrospective audit was completed for 9 months pre and post project implementation. A modified clinic format was introduced alongside oncology rather than stand alone. This also included a referral pathway development with visual prompts for medical staff within the clinical spaces. The malnutrition prevalence pre and post implementation results were compared against the Victorian state wide Cancer Malnutrition Point Prevalence Studies for each time point.

Results: Patients referred into the Nutrition Oncology Clinic increased following referral pathway implementation from 15 to 53 (353% increase). There was an increase in dietitian consultations from 11 to 46 (418% increase) and clinic attendance rates increased from 73% to 87%. Comparison with two point prevalence studies revealed an increased number of outpatients with malnutrition receiving dietetics consultations (23% to 71%). Only 7% of referrals were from medical staff, the majority from nursing and allied health.

Significance of finding for allied health: A new dietetic referral pathway increased patient referrals, attendance and facilitated early detection and management of malnutrition. It highlighted the importance of a multidisciplinary approach by coinciding patient’s dietetic and oncologist’s appointments to achieve these outcomes. Refresher training and further medical staff engagement may be needed to further increase patient referral from this group. Future research should consider measuring patient satisfaction and outcomes.