Implementation of Operative Standards in Cancer Surgery to Improve Patient Outcomes

实施癌症手术手术标准以改善患者预后

• 批准号: 10663235
• 负责人: Ko Un Park
• 金额: $ 26.55万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-11 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10663235
• 关键词: Accreditation; Address; Adherence; Adopted; Adoption; American; Axilla; Breast; Breast Cancer Patient; Cancer Center; Cancer Patient; Caring; Communities; Comprehensive Cancer Center; Computerized Medical Record; Data; Development; Development Plans; Diagnosis; Documentation; Education; Electronics; Elements; Engineering; Environment; Evaluation; Funding; Future; Goals; Guidelines; Health Services Research; Health system; Healthcare Systems; Hospitals; Institution; Interview; Link; Malignant Neoplasms; Maps; Mentors; Mentorship; Methods; Modification; Monitor; Multicenter Trials; Ohio; Operative Surgical Procedures; Outcome; Patient Care; Patient-Focused Outcomes; Patients; Physicians; Play; Police; Policies; Process; Professional Self Regulation; Qualitative Evaluations; Quality of Care; Quality of life; Reduce health disparities; Reporting; Research; Research Personnel; Research Project Grants; Research Proposals; Resources; Role; Sampling; Scientist; Standardization; Structure; Surgeon; Surgical Oncology; Techniques; Testing; Training; Training Programs; Universities; Variant; Woman; behavior change; breast surgery; cancer care; cancer diagnosis; cancer health disparity; cancer surgery; care delivery; care systems; career; career development; cost; design; effective intervention; effectiveness testing; evidence base; future implementation; implementation barriers; implementation design; implementation determinants; implementation facilitation; implementation framework; implementation outcomes; implementation science; implementation strategy; implementation tool; improved; improved outcome; individual patient; innovation; insight; malignant breast neoplasm; multidisciplinary; operation; pilot test; prevent; programs; prospective; scale up; standardized care; symposium; theories; therapy design; uptake; wasting

PROJECT SUMMARY The overall goal of this NCI K08 career development proposal is to facilitate Dr. Ko Un Park’s development into an independent investigator in cancer health services research focusing on implementation strategies that promote evidence-based care in surgical oncology and improve outcomes for cancer patients. Specifically, this proposal will apply insights from implementation science (IS) to the application of cancer surgery standards as set forth by the Commission on Cancer (CoC). The CoC is an accreditation organization that seeks to improve outcomes for individual patients with cancer through standardization of care delivery across 1500 hospitals providing care to some 70% of Americans with cancer. To date, the CoC has not paired its standards with implementation strategies; consequently, the standards’ implementation is often poor. The overarching goal of this project is to create stakeholder-driven strategies for adopting the use of the CoC’s new breast synoptic operative report (SOR) standard, by using tools from IS to identify and address barriers and facilitators to SOR implementation in diverse healthcare systems. To achieve this, in Aim 1 we will conduct key stakeholder interviews to identify barriers and facilitators to implementing breast SOR. In Aim 2, we will use evidence of implementation determinants to design strategies that facilitate breast SOR implementation. We will test the influence of the strategies on key implementation outcomes (e.g., feasibility, acceptability) in Aim 3. We hypothesize that we will identify both surgeon- and organization-level drivers of SOR implementation that can be leveraged to establish multi-level implementation strategies that will improve breast cancer outcomes. The planned training, proposed research project, multidisciplinary mentorship team, and exceptional research environment at The Ohio State University Comprehensive Cancer Center are ideally suited to address Dr. Park’s career goals. Her career development plan includes formal coursework in IS as well as directed readings and conferences. This education and mentored effort to execute the research proposal aid Dr. Park’s long-term career goal to become an independently funded implementation scientist-clinician to improve cancer patient outcomes by facilitating the implementation of professional self-regulation polices (i.e., CoC standards) in diverse health systems and cancer centers, and among physicians. With this training, Dr. Park will be able to successfully obtain funding for a subsequent prospective, multicenter trial testing the effectiveness of the strategies developed in the proposed project.

项目摘要 这项NCI K08职业发展计划的总体目标是促进Ko Un Park博士的发展 癌症卫生服务研究的独立研究者，重点是实施策略 促进手术肿瘤学中的循证护理并改善癌症患者的预后。具体来说，这是 提案将采用实施科学（IS）的见解，以应用癌症手术标准作为 由癌症委员会（COC）提出。 COC是一个旨在改善的认证组织 通过在1500家医院中标准化护理分娩的癌症患者的结果 为大约70％的美国人提供护理。迄今为止，COC尚未将其标准与 实施策略；因此，标准的实施通常很差。总体目标 该项目将创建利益相关者驱动的策略，以采用COC的新乳房概要 手术报告（SOR）标准，通过使用来自IS的工具来识别和解决SOR的障碍和促进者 在潜水员医疗系统中实施。为了实现这一目标，在目标1中，我们将进行关键的利益相关者 采访以识别障碍和促进者以实施乳房。在AIM 2中，我们将使用 实施确定设计促进乳房实施的策略。我们将测试 策略对目标3的影响（例如，可行性，可接受性）的影响3。 假设我们将确定SOR实施的外科医生和组织级别的驱动因素 杠杆化以建立多层实施策略，以改善乳腺癌的结果。这 计划培训，拟议的研究项目，多学科心态和杰出研究 俄亥俄州立大学综合癌症中心的环境非常适合解决Park博士 职业目标。她的职业发展计划包括正式的课程工作以及定向阅读和 会议。这种教育和修改了执行研究建议的努力援助帕克博士的长期 成为一名独立资助的实施科学家 - 临床医生以改善癌症患者的职业目标 通过支持在潜水员中实施专业自我调节政策（即COC标准）来取得成果 卫生系统和癌症中心，以及医生。通过这项培训，帕克博士将能够成功 为后来的前瞻性，多中心试验获得资金，以测试开发的策略的有效性 在拟议的项目中。