OGOSH: Optimising Germ Cell Ovarian Tumour Surveillance Habits in WA

Introduction: Malignant Germ Cell Ovarian Tumours (MGCOT) represent 2–5% of all ovarian tumours and occur in a younger population requiring long-term follow-up. Currently, three international guidelines recommend specific follow-up schedules for MGCOT surveillance. However, due to differences between these guidelines and cancellation of outpatient services due to COVID-19, there has been significant variation in the follow-up of patients with MGCOT in Western Australia (WA).

Aims: This project aimed to improve service provision to WA MGCOT survivors by ensuring optimal follow-up and discharge planning.

Methods: With the involvement of key stakeholders, the process of outpatient follow-up was mapped from referral to discharge. A subsequent audit was conducted to demonstrate differences in current practice and identify areas for improvement. Based on the results, root cause analysis and solution generation sessions were conducted with relevant stakeholders to identify the issues and implement relevant solutions.

Results and Discussion: The audit showed substantial variation in follow-up schedules, investigations performed for surveillance and duration of follow-up. Sixty per cent of patients were discharged from the service with no advice provided to their primary healthcare provider. Root cause analysis noted differences in international guidelines, long waiting periods for outpatient appointments and lack of a standardised cancer survivorship care plan upon discharge as the driving factors.

Conclusion: Urgent appointments were made for patients overdue for follow-up. Standardised discharge letters were implemented across the service to improve communication upon discharge. A local protocol will be designed considering these results to achieve standardised care for patients with MGCOT across WA.