Closing the distance and the Specialist Nursing Optimal Placement Tool (SN-OPT): Strategic placement of specialist cancer nurses to achieve resource and geographic equity in Australia.

Abstract

11082 Background: Cancer workforce planning that enables effective specialist nurse placement is critical for delivering high-quality, patient-centered care. Inequitable access to specialist nursing represents a significant gap in cancer care delivery. No standardized tools assess specialist cancer nursing resource needs across national healthcare systems. We developed SN-OPT, an innovative resource allocation tool, using 30 new centrally funded specialist melanoma nurse positions for Australia as a case study. Methods: A multidisciplinary panel developed SN-OPT via expert consensus, incorporating three data domains: Clinical Infrastructure Assessment: Analysis of facility capabilities including multidisciplinary team (MDT) structures, clinical trial programs, and existing nursing and support services Demand Assessment: Quantitative analysis of case load, treatment complexity, and nursing workload benchmarks Health Equity: Population-level analysis incorporating geographic accessibility and socioeconomic disadvantage SN-OPT combines cancer incidence data with facility metrics to allocate nursing resources operating within a MDT framework. Equity assessment utilized Australian Statistical Geography Standard, Index of Relative Socio-Economic Disadvantage and Travel Time to Hospitals in Australia dataset. Results: SN-OPT evaluated 46 Australian facilities for melanoma nursing allocation. The weighted scoring algorithm ranked 33 sites for nurse allocation, with a mean allocation of 0.87 full time equivalent (FTE) positions per metro facility and 0.64 FTE per regional facility. The tool achieved equitable geographic distribution of specialist nursing expertise: regional facilities, treating 25% of patients, received 36% of nursing FTE (167 patients/FTE/year). Metro facilities, managing 75% of patients, received 64% of FTE (212 patients/FTE/year). Allocations largely aligned with facility-determined resource need, with 58% receiving their requested FTE. Among the remaining facilities, median allocation variance was -0.4 FTE (range -0.1 -1.0). On a population level, 89% of Australians would have geographic access to specialist melanoma nursing care within 2-hours of travel, including 81% of the most socioeconomically disadvantaged regions. Conclusions: SN-OPT offers a reproducible framework for data-driven allocation of specialist cancer nurses. While implemented using melanoma nurses as a case study, SN-OPT's framework has the potential to be adapted across cancer streams and countries, providing a scalable approach to equitable cancer workforce planning. Early implementation balances clinical service delivery and demand requirements within a MDT framework, while allowing adequate geographical access including socioeconomically disadvantaged regions.