Exploring the interpersonal-, organization-, and system-level factors that influence the implementation and use of an innovation-synoptic reporting-in cancer care

Implementation Science

Joan Sargeant²  Eva Grunfeld¹  Geoffrey A Porter⁴  Robin Urquhart³ 

[1] Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, Ontario, Canada;Continuing Medical Education, Faculty of Medicine, Dalhousie University, Clinical Research Centre, 5849 University Avenue, Halifax, Nova Scotia, Canada;Interdisciplinary PhD Program, Faculty of Graduate Studies, Dalhousie University, Henry Hicks Academic Administration Building, 6299 South Street, Halifax, Nova Scotia, Canada;Department of Community Health and Epidemiology, Dalhousie University, Centre for Clinical Research, 5790 University Avenue, Halifax, Nova Scotia, Canada

关键词: Implementation;    Innovation;    Synoptic report;    Cancer;   

Others  :  829009
DOI  :  10.1186/1748-5908-7-12

 received in 2011-11-29, accepted in 2012-03-01,  发布年份 2012

【 摘 要 】

Background

The dominant method of reporting findings from diagnostic and surgical procedures is the narrative report. In cancer care, this report inconsistently provides the information required to understand the cancer and make informed patient care decisions. Another method of reporting, the synoptic report, captures specific data items in a structured manner and contains only items critical for patient care. Research demonstrates that synoptic reports vastly improve the quality of reporting. However, synoptic reporting represents a complex innovation in cancer care, with implementation and use requiring fundamental shifts in physician behaviour and practice, and support from the organization and larger system. The objective of this study is to examine the key interpersonal, organizational, and system-level factors that influence the implementation and use of synoptic reporting in cancer care.

Methods

This study involves three initiatives in Nova Scotia, Canada, that have implemented synoptic reporting within their departments/programs. Case study methodology will be used to study these initiatives (the cases) in-depth, explore which factors were barriers or facilitators of implementation and use, examine relationships amongst factors, and uncover which factors appear to be similar and distinct across cases. The cases were selected as they converge and differ with respect to factors that are likely to influence the implementation and use of an innovation in practice. Data will be collected through in-depth interviews, document analysis, observation of training sessions, and examination/use of the synoptic reporting tools. An audit will be performed to determine/quantify use. Analysis will involve production of a case record/history for each case, in-depth analysis of each case, and cross-case analysis, where findings will be compared and contrasted across cases to develop theoretically informed, generalisable knowledge that can be applied to other settings/contexts. Ethical approval was granted for this study.

Discussion

This study will contribute to our knowledge base on the multi-level factors, and the relationships amongst factors in specific contexts, that influence implementation and use of innovations such as synoptic reporting in healthcare. Such knowledge is critical to improving our understanding of implementation processes in clinical settings, and to helping researchers, clinicians, and managers/administrators develop and implement ways to more effectively integrate innovations into routine clinical care.

【 授权许可】

   
2012 Urquhart et al; licensee BioMed Central Ltd.

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