Outstanding Changemaker award goes to Peter Mac Perioperative Medicine Team

The Perioperative Medicine Team led by Professor Bernhard Riedel at Peter MacCallum Cancer Centre has been awarded the Outstanding Changemaker award in the 2025 VCCC Alliance Leading for Impact Awards. 

The multidisciplinary team was recognised for developing a comprehensive model of care to improve access, safety and outcomes for cancer patients across the VCCC Alliance member hospitals and beyond. 

The team built a system with six integrated steps including triaging patients for optimisation with prehabilitation before surgery, safe recovery, and readiness for cancer therapy after initial treatment. These steps expand on the high-quality anaesthesia and pain medicine delivered by the service. 

A Peter Mac initiative, the model has elements that have been implemented at other networks, a co-designed prehabilitation toolkit available nationally and internationally, and published research and clinical guidelines to widely share the innovations that have been developed.

“The team has led a unique approach to patient care, service delivery and research that is equitable, consumer-centred, and scalable regionally and nationally,” said Executive Director of Cancer Research at Peter Mac, Prof Ricky Johnstone. 

Six components, one pathway 

1. Prehabilitation (Fit-4-Surgery, F4S) program: Risk assessment and triage for patients suitable for optimisation through prehabilitation. This program has been refined over many years and recently packaged into The Prep-4-Cancer Surgery Toolkit, suitable for patients and available to clinicians nationally and internationally since August 2025. Developing this resource involved Peter Mac staff from Allied Health, Nursing, Clinical Psychology and Anaesthesia and was co-designed with Western Health, Bendigo Health, Mercy Health, the Royal Women's Hospital, Northwestern Melbourne Primary Health Network, Cancer Council Victoria, and consumers. 
2. Enhanced Recovery After Surgery plus prehabilitation (ERAS+), a clinical pathway to reduce unwarranted variations in care provision, was developed at Peter Mac and then implemented at the West Metro Health Service Partnership which includes Peter Mac, Royal Melbourne Hospital, Western Health, and The Royal Women's – recognised at the 2024 Victorian Public Healthcare Award for Excellence in Value-based Healthcare.
3. Shared Decision-Making (SDM) service, ensuring high-risk surgical decisions reflect the patient’s voice and their personal values and goals.
4. Enhanced Care Unit (ECU) staffed by the High Acuity Team, extends high quality care into the 'golden hours' after surgery. It was recognised at the Victorian Public Health Care 2024 Awards (Safer Care Victoria Award for Safety Improvement) and has now provided enhanced postoperative care for more than 1,750 patients.
5. High Acuity Team (HAT), who conduct postoperative ward rounds to prevent and reduce postoperative complications and who respond to deteriorating patients throughout the hospital. HAT provided perioperative care to more than 2,738 patients and responded to 1,828 rapid-response events in FY24-25.
6. Rehabilitation: Links eligible patients into rehabilitation to enable patients to recover fitness, return to the community, and start cancer treatment quickly.

Research

Ongoing research studies funded by NHMRC/MRFF grants that ensure continuous innovation and spread include: PRECAST Al for surgical risk prediction and decision-support; STARRS virtual surgery school for patient education; PRIORITY-CONNECT-2 – a virtual prehabilitation hub – for delivering multicentre prehabilitation; PPGX for pharmacogenomic guided perioperative care; PROSPER for postoperative pain management after major surgery. 

PRIORITY-CONNECT 2 expands virtual prehabilitation across Victoria and NSW in partnership with the Royal Prince Alfred Hospital, Sydney. It is funded by MRFF and received the 2025 Sydney Excellence Award for Health Research and Innovation.

The PRECAST Al infrastructure program, the multicentre PREHAB trial, and registry-embedded trials position the team to deliver generalisable, high-value perioperative care is conducted with industry partners and collaborates with internationally (Copenhagen, Denmark). 

Other international collaborations include the FASTWALK study (Toronto, Canada), the PREHAB multicentre RCT (Cologne, Germany), and the ENCORE-RIOT study (Karolinska Hospital, Sweden).  

The team also contributes to numerous clinical best-practice guidelines, including the international ERAS guidelines for colorectal surgery and the Perioperative Quality Improvement Initiative (POQI, UK and US) consensus guidelines across numerous domains, including perioperative nutrition, shared-decision making (SDM), value-based health care, and enhanced care units.  

Equity  

Equity and consumer voice are designed into the perioperative medicine pathway. Universal prehabilitation is delivered through the Virtual Surgery School, translating the essentials of preparing for surgery into five languages. More than 470 unique users were engaged in initial months, across 760 sessions, with almost 70 per cent outside metropolitan Melbourne, directly addressing geographic and language barriers to preparation.

Phone and video clinics are routine, and tele-prehabilitation is scaled through PRIORITY and the PRIORITY-CONNECT2 research studies, ensuring rural and regional patients can access the same research and evidence-based preparation as those in Parkville. Allied health prehabilitation interventions are also provided through telehealth consultations, which improves access to prehabilitation for regional and rural patients.

Patient reported outcome measures (PROMs) and patients reported experience (PREMS) inform shared planning for prehabilitation, surgery, and recovery, and the patient voice is ensured through Shared Decision-Making.