Background: Breast cancer is the most common malignancy among women in Gippsland, with regional survival outcomes continuing to lag behind metropolitan benchmarks. Timely access to neoadjuvant chemotherapy (NACT) for high-risk patients remains a critical challenge due to fragmented care and lack of a coordinated approach, despite the existence of Optimal Care Pathways.
Objective: To implement a stakeholder-informed, standardised care pathway aimed at improving timely access to NACT for high-risk breast cancer patients across the Gippsland region.
Implementation Process: A structured, multi-phase implementation approach is underway, guided by the CFIR, COM-B, PDSA, McKinsey 7S, Donabedian, and RE-AIM frameworks. Initial phases included stakeholder mapping, system diagnostics, and identification of barriers and enablers across organisational and behavioural domains. A working group was established to co-design intervention components such as standardised referral templates, early triage protocols, and streamlined diagnostic-to-treatment timelines. Integration with existing hospital systems and multidisciplinary meeting workflows was prioritised to support continuity and communication. Implementation milestones are being tracked through audit tools, process mapping, and regular feedback loops with clinical and administrative teams.
Progress to Date: Key enablers include strong clinical leadership, cross-site engagement, and executive support. Early wins include finalisation of a referral template, agreement on triage timelines, and alignment of MDM scheduling. Ongoing activities focus on data collection systems, patient tracking, and staff training.
Conclusion: This project illustrates the application of implementation science principles to address service delivery gaps in regional cancer care. Progress to date highlights the importance of collaborative governance, adaptive planning, and system integration to drive sustainable change.