Development of a Novel Statewide Learning Collaborative to Increase Lung Cancer Guideline Adherence and Improve Cancer Care Delivery

项目摘要/摘要 肺癌是美国癌症相关死亡的主要原因，占221,200人 每年新增病例和158,040例死亡(超过结肠癌、乳腺癌和前列腺癌的总和)。尽管 是否有完善的护理指南，遵守这些建议的情况是不同的，而且往往 可怜。帮助医院实现对指南的最佳遵守，关于遵守的有意义的比较数据 必须首先收集肺癌护理中可衡量的质量指标，以便确定 进步。一旦有了这样的初步遵守数据，评估证据的具体障碍- 以护理为基础的护理将指导制定干预措施，以解决障碍。一旦干预措施 结合成质量改进工具，将在一系列医院对实施情况进行系统测试 需要评估有效性、可行性、可持续性和普适性。该项目建议使用一个 评估肺癌治疗中遵守指南障碍的学习协作模式并确定 解决办法。该提案的最终目标是改善指导方针的遵从性并减少不必要的情况 肺癌护理的多样性。从医院适应和实施评估中吸取的教训 干预措施将导致确定共同原则，以指导不同类型的医院 提供有效的、遵守指南的肺癌护理。这项工作将导致一个可推广的模型来评估 癌症护理质量，了解变化的潜在原因，提高对国家指南的遵守 并传播基于证据的最佳做法。 候选人奥德尔博士是一名拥有临床和研究资格的普通胸外科医生。 着力抓好肺癌的治疗。他的临床培训和先前的研究经验衡量结果 和评估干预措施，以优化肺癌治疗和在伊利诺伊州外科质量范围内工作 改进合作组织(ISQIC)为他的这项提议做了独特的准备。奥德尔博士的职业目标是 成为一名独立出资的调查员，将先进的定量和定性分析结合在一起 具有实施和传播科学的专业知识，以促进有效的、以证据为基础的癌症护理 虽然以医院为基础的项目。为了实现这一目标，他需要在颁奖期间接受专门的额外培训。 在3个领域获得专门知识的时间：(1)定量评估方法，(2)定性研究方法， (3)实施与传播学。导师团队，经验丰富的合作者， ISQIC的制度环境和强大的质量改进基础设施非常适合这些 教育目标。最后，该项目是实现我的职业发展目标和意愿的理想工具 让奥德尔博士有机会直接应用在定性方法中学到的技能和技巧， 量化改进原则和实施科学，并将使他能够执行持续的、 在癌症护理服务方面创新、独立研究。

Project Summary / Abstract Lung cancer is the leading cause of cancer-related mortality in the United States, accounting for 221,200 new cases and 158,040 deaths annually (more than colon, breast and prostate cancers combined). Despite the presence of well-developed guidelines for care, adherence to these recommendations is variable and often poor. To help hospitals achieve optimal adherence to guidelines, meaningful comparative data on adherence to measurable quality indicators in lung cancer care must first be gathered in order to identify areas for improvement. Once such preliminary adherence data are available, assessing specific barriers to evidence- based care will guide the development of interventions to address the barriers. Once the interventions are combined into a quality improvement tool, systematic testing of implementation in a range of hospitals will be needed to assess efficacy, feasibility, sustainability, and generalizability. This project proposes to use a learning collaborative model to assess barriers to guideline adherence in lung cancer care and identify solutions. The ultimate goal of the proposal is to improve guideline adherence and decrease unwanted variation in lung cancer care. Lessons learned through evaluation of hospital adaptation and implementation of interventions will lead to identification of common principles that can guide diverse types of hospitals in providing effective, guideline adherent lung cancer care. This work will lead to a generalizable model to assess cancer care quality, understand the underlying reasons for variability, improve adherence to national guidelines and disseminate evidence-based best practices. The candidate, Dr. Odell, is a board-certified general thoracic surgeon with both a clinical and research focus on the treatment of lung cancer. His clinical training and prior research experience measuring outcomes and assessing interventions to optimize lung cancer treatment and working within the Illinois Surgical Quality Improvement Collaborative (ISQIC) has uniquely prepared him for this proposal. Dr. Odell's career goal is to become an independently funded investigator who combines advanced quantitative and qualitative analytics with expertise in implementation and dissemination science to facilitate effective, evidence-based cancer care though hospital-based programs. To fulfill this goal, he will need specific additional training during this award period to gain expertise in 3 areas: (1) quantitative evaluation methodology, (2) qualitative research methods, and (3) implementation and dissemination science. The mentorship team, experienced collaborators, institutional environment and robust quality improvement infrastructure of ISQIC are ideally suited to these educational goals. Finally, the project serves as an ideal vehicle for my career development objectives and will afford Dr. Odell the opportunity to directly apply the skills and techniques learned in qualitative methods, quantitative improvement principles, and implementation science and will position him to perform ongoing, innovate, independent research in cancer care delivery.