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National Thoracic Surgery Standards Implementation: Barriers, Enablers, and Opportunities

Background: Diagnosis and surgical treatment decision making for thoracic cancers is complex. Moreover, there is demonstrated variability in how each province in Canada delivers cancer care, resulting in disparities in patient outcomes. Recently, the Canadian Partnership Against Cancer (CPAC) publis...

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Autores principales: Arnaout, Angel, Prashad, Anubha, Dunk, Nadine, Rogers, Jess, Edwards, Annemarie, Argent-Katwala, Mary, Finley, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903269/
https://www.ncbi.nlm.nih.gov/pubmed/33450804
http://dx.doi.org/10.3390/curroncol28010043
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author Arnaout, Angel
Prashad, Anubha
Dunk, Nadine
Rogers, Jess
Edwards, Annemarie
Argent-Katwala, Mary
Finley, Christian
author_facet Arnaout, Angel
Prashad, Anubha
Dunk, Nadine
Rogers, Jess
Edwards, Annemarie
Argent-Katwala, Mary
Finley, Christian
author_sort Arnaout, Angel
collection PubMed
description Background: Diagnosis and surgical treatment decision making for thoracic cancers is complex. Moreover, there is demonstrated variability in how each province in Canada delivers cancer care, resulting in disparities in patient outcomes. Recently, the Canadian Partnership Against Cancer (CPAC) published pan-Canadian evidence-based standards for the care of thoracic surgery cancer patients. This study was undertaken to assess the degree to which these standards were currently met in practice and to further understand the determinants to their implementation nationally. Methods: This study was undertaken in two parts: (1) a national survey of thoracic surgeons to assess the perceived extent of implementation of these standards in their institution and province; and (2) formation of a focus group with a representative sample of thoracic surgeons across Canada in a qualitative study to understand the determinants of successful standards implementation. Results: 37 surgeons (33% response rate) participated in the survey; 78% were from academic hospitals. The top categories of standards that were under-implemented included (a) quality assurance processes, data collection and clinician audit and feedback, and (b) ongoing regional planning and workload assessments for thoracic surgeons, and (c) pathology turnaround time target of two weeks and the use of a standardized synoptic pathology report format. Enablers, barriers, and opportunities for standards implementation contextualized the discussion within the focus group. Conclusion: Study results demonstrated variation in the implementation of surgery standards across Canada and identified the determinants to the delivery of high quality surgical care. Future work will need to include the promotion and development of quality improvement strategies and effective resource allocation that is aligned with the implementation of thoracic cancer surgery standards in order to improve patient outcomes.
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spelling pubmed-79032692021-02-25 National Thoracic Surgery Standards Implementation: Barriers, Enablers, and Opportunities Arnaout, Angel Prashad, Anubha Dunk, Nadine Rogers, Jess Edwards, Annemarie Argent-Katwala, Mary Finley, Christian Curr Oncol Article Background: Diagnosis and surgical treatment decision making for thoracic cancers is complex. Moreover, there is demonstrated variability in how each province in Canada delivers cancer care, resulting in disparities in patient outcomes. Recently, the Canadian Partnership Against Cancer (CPAC) published pan-Canadian evidence-based standards for the care of thoracic surgery cancer patients. This study was undertaken to assess the degree to which these standards were currently met in practice and to further understand the determinants to their implementation nationally. Methods: This study was undertaken in two parts: (1) a national survey of thoracic surgeons to assess the perceived extent of implementation of these standards in their institution and province; and (2) formation of a focus group with a representative sample of thoracic surgeons across Canada in a qualitative study to understand the determinants of successful standards implementation. Results: 37 surgeons (33% response rate) participated in the survey; 78% were from academic hospitals. The top categories of standards that were under-implemented included (a) quality assurance processes, data collection and clinician audit and feedback, and (b) ongoing regional planning and workload assessments for thoracic surgeons, and (c) pathology turnaround time target of two weeks and the use of a standardized synoptic pathology report format. Enablers, barriers, and opportunities for standards implementation contextualized the discussion within the focus group. Conclusion: Study results demonstrated variation in the implementation of surgery standards across Canada and identified the determinants to the delivery of high quality surgical care. Future work will need to include the promotion and development of quality improvement strategies and effective resource allocation that is aligned with the implementation of thoracic cancer surgery standards in order to improve patient outcomes. MDPI 2021-01-13 /pmc/articles/PMC7903269/ /pubmed/33450804 http://dx.doi.org/10.3390/curroncol28010043 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Arnaout, Angel
Prashad, Anubha
Dunk, Nadine
Rogers, Jess
Edwards, Annemarie
Argent-Katwala, Mary
Finley, Christian
National Thoracic Surgery Standards Implementation: Barriers, Enablers, and Opportunities
title National Thoracic Surgery Standards Implementation: Barriers, Enablers, and Opportunities
title_full National Thoracic Surgery Standards Implementation: Barriers, Enablers, and Opportunities
title_fullStr National Thoracic Surgery Standards Implementation: Barriers, Enablers, and Opportunities
title_full_unstemmed National Thoracic Surgery Standards Implementation: Barriers, Enablers, and Opportunities
title_short National Thoracic Surgery Standards Implementation: Barriers, Enablers, and Opportunities
title_sort national thoracic surgery standards implementation: barriers, enablers, and opportunities
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903269/
https://www.ncbi.nlm.nih.gov/pubmed/33450804
http://dx.doi.org/10.3390/curroncol28010043
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