Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2026
Summary
This project sought to codesign presurgical care to better support men undergoing prostate cancer surgery, aiming to improve quality of care, clinical outcomes, and patient experience.
Dates: April 2025 - January 2026
Implementation sites: STARS
Partnerships: Patients who had previously attended the clinic.
Aim
To co-design a presurgical care resource to support patients who are impacted by prostate cancer and treated with radical prostatectomy.
Outcomes
We used co-design and Nominal Group Technique to determine key priorities for presurgical care. These were (1) Early Screening, (2) Clear Processes of Care, and (3), Prostatectomy Specific Information.
Focusing on the educational priority, a series of educational videos was developed to support patients preparing for RARP at STARS. This includes a general ‘Surgery at STARS’ video and three prostatectomy specific modules covering the preoperative, perioperative, and postoperative phases. A structured implementation plan was developed to integrate the educational videos into clinical workflows. This ensures consistent processes, clear oversight, regular review and long-term sustainability of the resources.
Background
A body of work was done to inform the project. Firstly, a systematic review was completed to establish an evidence base informing the content and focus of presurgical care. This review highlighted the variation in presurgical interventions but reinforced the value of a multidisciplinary approach. It also emphasised that presurgical strategies are most effective when adapted to local resources and contexts. Secondly, an evaluation of presurgical prostatectomy care at STARS was conducted, incorporating qualitative interviews with clinical teams, an unmet needs survey with patients, an audit of presurgical care, and review of emergent post-prostatectomy care data. The evaluation identified variation in processes and the care received by patients referred to STARS from multiple Metro North facilities. These findings were then collated and presented to a steering
committee of clinical experts. Nominal Group Technique was used to identify key priority areas for presurgical care. The Nominal Group Technique identified three overarching priority areas: * Early screening: The need for timely assessment to confirm surgical
suitability and allow adequate time for presurgical optimisation, including consideration of cultural, language, health literacy, mental health, and transport needs. * Clear processes for care: A clear pathway of care for robotic assisted radical prostatectomy
(RARP) was mapped from preoperative assessment through to recovery, highlighting points where informational support could be strengthened. * Prostatectomy specific education: Patients require tailored, procedure specific information to help them prepare for
surgery and understand what to expect during recovery. Early screening and the development of care pathways were projects being led by teams in STARS. Our focus was to address the educational priority by co-designing prostatectomy specific information resources
to support patients and clinicians.
Methods
Findings from an evaluation of prostatectomy care at STARS were presented to a multi‑disciplinary steering committee of clinical experts to inform and guide the design of pre‑-surgical care. The Nominal Group Technique (NGT) was used, with meetings conducted via Microsoft Teams.
The NGT process included:
(1) Silent generation of key prehabilitation concepts
(2) Structured sharing of ideas
(3) Group discussion to clarify and refine emerging priorities, resources, and potential supporting strategies
(4) Ranking in order of priority. Members were asked to submit their top five priorities via email, allocating scores totalling 100. These were compiled and analysed in a non‑identifiable format. During a follow-up meeting, the committee reviewed the aggregated ranking results and key discussion points. To address the educational priority for presurgical prostatectomy care, members explored options for delivery, including preferred media, content, and timing. An example educational resource was demonstrated, and feedback was used to inform the development of a draft pre‑surgical educational video.
Key time points were identified for optimal implementation. An implementation plan was then created with a clear description for project scope. The primary focus of the implementation plan was to embed the developed educational videos into routine clinical practice with a clear plan for integration, oversight, ongoing review, and evaluation. The Videos will be housed on the Metro North Vimeo Webpage with access provided through QR codes. QR codes will be incorporated into patient informational materials and made available to patients at key timepoints along the surgical pathway. This includes at pre-anaesthetic assessment, discharge from the ward following surgery, and at trial of void appointments. Endorsement has been provided by the Surgical and Procedural Services Executive Committee who will provide strategic oversight and ensure alignment with organisational priorities. The project team will work closely with Nursing Teams in the Outpatient Department and Pre-anaesthetic Clinic to ensure successful integration into existing workflows. Regular communication will occur through Surgical and Procedural Meetings, Safety and Quality Meetings, and email updates with the Steering Committee. An established review process will ensure the content remains aligned with evidence-based practice and is relevant to local needs.
Discussion
The successful delivery of this project was dependent on engagement with clinicians, strong relationships with key stakeholders, and organisational support. Involvement from the steering committee was crucial in developing an intervention that was both clinically relevant and acceptable. Open communication channels and a collaborative culture within STARS allowed clinicians to share insights about workflow, patient expectations, and practical constraints. Partnerships with clinicians in other Metro North facilities further enhanced the project by facilitating a broader consideration of enablers and barriers.
Engaging with clinicians was crucial for designing resources that were both acceptable and practical. Iterative review by the steering committee, followed by feedback from the broader clinical team, underscored the importance of co-design in creating content that was accurate, culturally sensitive, and tailored to patient needs. Additionally, the virtual format of the meetings enhanced accessibility and encouraged participation, especially among stakeholders at partnering facilities.
The project also had limitations. As the development process relied on nominated clinical representatives, feedback may not fully reflect the views of all staff involved in pre‑-operative prostatectomy care. Additionally, the intervention was developed within the workflows of STARS, and some components may require adaptation for sites with different models of care. Despite this, the project has strong potential for scalability across Queensland Health. The structured methodology used throughout, including the use of Nominal Group Technique to guide co-design and clearly defined implementation plan, provides a systematic approach that can be readily adapted to other diseases, treatment pathways, and clinical specialities. There is a widespread need for consistent, high‑quality patient education across facilities, and the flexible digital format of the educational videos supports easy integration into diverse clinical environments.
This model is both sustainable and adaptable, with the capacity to enhance patient understanding and experience at scale. This comprehensive body of work will be followed by a formal evaluation phase to assess the effectiveness, usability, and the impact of the co-designed resources. The evaluation will incorporate feedback from key stakeholders, clinicians, and patients to ensure it captures diversity and reflects practical application within everyday clinical workflows. It will examine accessibility, usage data, relevance to clinical practice, acceptability of the content, and overall patient and clinical experience.
Findings from the evaluation will guide refinement of the resources and inform opportunities for broader implementation across services.
References
1. Bird, M., McGillion, M., Chambers, E.M. et al. A generative co-design framework for healthcare innovation: development and application of an end-user engagement framework. Res Involv Engagem 7, 12 (2021). https://doi.org/10.1186/s40900-021-00252-7
2. Paterson C, Roberts C, Kozlovskaia M, Nahon I, Schubach K, Sara S, et al. The effects of multimodal prehabilitation interventions in men affected by prostate cancer on physical, clinical and patient reported outcome measures: A systematic review. Semin Oncol Nurs. 2022;38(5):151333. https://doi.org/10.1016/j.soncn.2022.151333
3. Manera, K., Hanson, C.S., Gutman, T., Tong, A. (2019). Consensus Methods: Nominal Group Technique. In: Liamputtong, P. (eds) Handbook of Research Methods in Health Social Sciences. Springer, Singapore. https://doi.org/10.1007/978-981-10-5251-4_100
Key contact
Dr Natasha Roberts
Nursing Conjoint Clinical Research Fellow
STARS
Metro North HHS
Email: natasha.roberts@health.qld.gov.au