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

开发新型全州学习协作，以提高肺癌指南的遵守率并改善癌症护理服务

• 批准号: 9763344
• 负责人: David D. Odell
• 金额: $ 16.75万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9763344
• 关键词: Accounting; Address; Adherence; American; Annual Reports; Area; Award; Cancer Etiology; Cancer Patient; Caring; Cessation of life; Clinical; Clinical Research; Clinical Trials; Colon Carcinoma; Comorbidity; Complex; Consensus; Data; Development; Diagnostic tests; Discipline; Effectiveness; Environment; Evaluation; Evaluation Methodology; Funding; Future; Goals; Guideline Adherence; Guidelines; Health Care Costs; Hospitals; Illinois; Image; Infrastructure; Intervention; Knowledge; Learning; Malignant Neoplasms; Malignant neoplasm of lung; Malignant neoplasm of prostate; Measurable; Measurement; Measures; Medical Oncology; Mentorship; Methods; Modeling; Monitor; Operative Surgical Procedures; Outcome Measure; Patients; Performance; Positioning Attribute; Postoperative Period; Prevalence; Process; Provider; Publishing; Qualitative Methods; Qualitative Research; Quality Indicator; Quality of Care; Quantitative Evaluations; Radiation Oncology; Recommendation; Research; Research Methodology; Research Personnel; Science; Societies; Specialist; Staging; Techniques; Testing; Thoracic Surgeon; Thoracic Surgical Procedures; Training; United States; Variant; Work; base; cancer care; cancer therapy; cancer type; care delivery; care systems; career; career development; comparative; cost; evidence base; evidence based guidelines; experience; hospital performance; implementation science; improved; innovation; malignant breast neoplasm; medical specialties; molecular marker; mortality; novel; oncology; preference; programs; skills; success; therapy development; tool; uptake

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.

项目摘要 /摘要 肺癌是美国与癌症相关死亡率的主要原因，占221,200 每年新病例和158,040例死亡（比结肠，乳腺癌和前列腺癌的总和更多）。尽管 有完善的护理指南，遵守这些建议是可变的，而且通常 贫穷的。为了帮助医院实现最佳遵守指南，有关依从性的有意义的比较数据 必须首先收集肺癌护理中可测量的质量指标，以确定 改进。一旦获得此类初步依从性数据，评估了证据的特定障碍 - 基于的护理将指导开发干预措施以解决障碍。一旦干预措施 合并为质量改进工具，将在一系列医院中进行实施的系统测试 需要评估功效，可行性，可持续性和普遍性。该项目建议使用 学习协作模型，以评估肺癌护理中指南遵守的障碍并确定 解决方案。该提案的最终目标是提高指导方向的遵守并减少不必要的 肺癌护理的变化。通过评估医院适应和实施的经验教训 干预措施将导致确定可以指导各种类型医院的常见原则 提供有效的指南辅助肺癌护理。这项工作将导致一个可概括的模型来评估 癌症护理质量，了解可变性的根本原因，提高遵守国家准则 并传播基于证据的最佳实践。 候选人Odell博士是董事会认证的一般胸外科医生，既有临床和研究 专注于治疗肺癌。他的临床培训和先前的研究经验来衡量结果 并评估干预措施以优化肺癌治疗并在伊利诺伊州手术质量中工作 改进协作（ISQIC）为他为此提案做好了唯一的准备。奥德尔博士的职业目标是 成为一名独立资助的研究者，他结合了高级定量和定性分析 具有实施和传播科学方面的专业知识，以促进有效的循证癌症护理 虽然基于医院的计划。为了实现这一目标，他将需要在此奖励期间进行特定的额外培训 在3个领域获得专业知识的时期：（1）定量评估方法，（2）定性研究方法， （3）实施和传播科学。指导团队，经验丰富的合作者， 伊斯克的机构环境和良好的质量改进基础设施非常适合这些 教育目标。最后，该项目是我职业发展目标的理想工具，将 为Odell博士提供直接运用以定性方法学习的技能和技术的机会， 定量改进原则和实施科学，并将他定位为持续的 创新的，独立的癌症护理分娩研究。