Aims
To develop a transparent, evidence-informed method for prioritising population groups for a diversity, equity and inclusion action plan at a specialist cancer centre, ensuring priorities reflected inequity severity and system responsiveness rather than population size alone.
Methods
Twelve priority populations identified in the Victorian Cancer Plan were assessed through multi-method evidence synthesis. Internal activity data from 47,832 unique patients (2025-26 FY) estimated population scale. A rapid review synthesised Australian cancer-specific evidence on access, experience and outcomes. An environmental scan mapped 80 services, programs and initiatives, while a hospital-wide Gemba walk examined navigation, communication and support services. Strategic mapping assessed alignment with patient and carer experience objectives and relevant policy frameworks. Subject-matter experts and the business intelligence unit supported population definitions and validated the methodology. The project team scored each population using an equally weighted multi-criteria matrix: scale, inequity severity, system gap, system maturity (inverse), strategic alignment and duplication risk (inverse). Each criterion was scored 1-3 based on the evidence.
Results
Composite scores ranged from 1.7 to 2.8 (maximum 3); higher scores indicated greater priority. Regional and rural communities, people experiencing mental health issues, and people experiencing socioeconomic disadvantage each scored 2.8. Their combination of severe inequity, substantial structural gaps, low system maturity and strong strategic alignment indicated a need for foundational equity redesign. Four populations required equitable service scaling, while five required stronger integration within existing governance and practice. The three highest-priority populations were formally endorsed and used to co-design the DEI Action Plan with consumers representing these populations.
Conclusions
This method translated broad equity commitments into proportionate organisational responses by considering population need alongside system capability. It provided a transparent rationale for directing resources towards structural redesign while reducing duplication. The approach may be adaptable to other cancer services seeking to prioritise equity initiatives within finite resources.