Aims
Implementation and early outcomes of the Cancer Institute NSW (CINSW) Patient Reported Measures (PRMs) program within Sydney Local Health District (SLHD), sharing lessons for broader adoption.
Methods
SLHD was the final NSW Health District to implement the statewide PRMs program due to electronic medical record constraints. To support equitable participation, SLHD partnered with CINSW to develop an alternative platform and implementation model. A working group guided a staged rollout in September 2025 across Royal Prince Alfred Hospital haematology and Concord Cancer Centre metastatic breast cancer services. Patients completed electronic symptom and distress surveys, with Cancer Nurse Consultants responding to results, initiating referrals, discussing findings with clinicians, and promoting self-management. Monthly CINSW meetings, clinician education and workflow redesign supported implementation.
Results
Initial implementation was met with clinician uncertainty around workflow impacts and PRM alert management. To address this, two clinical champions piloted the platform, tested workflows, and developed local solutions. Following process refinement and role clarification, uptake accelerated, with strong clinician commitment to ongoing use. By 30 June 2026, 176 surveys were completed by 38 unique patients. Clinicians reported that PRMs “created valuable talking points, opening doors to detailed wellbeing conversations” and “uncovered patient issues that would have been missed”. Recognition and validation of patient distress was a powerful intervention in itself. Staff confidence in PRM administration, interpretation and alert management increased as PRMs became embedded in routine practice. Concord subsequently expanded PRMs to early breast cancer patients, with psycho-oncology services exploring future participation.
Conclusions
Despite implementation barriers, collaboration between CINSW and SLHD enabled participation in the statewide PRMs program through an alternate platform. A clinician-led approach, with local champions, proactive troubleshooting, workflow adaptation, and triaged PRM management enabled sustainable integration into routine cancer care. SLHD's experience demonstrates how targeted implementation strategies can overcome system constraints and advance person-centred care.