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

项目概要/摘要 肺癌是美国癌症相关死亡的主要原因，占22.12万 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 存在完善的护理指南，遵守这些建议是可变的，通常 扶贫为了帮助医院实现对指南的最佳遵守， 必须首先收集肺癌护理中可衡量的质量指标，以确定 改进.一旦这些初步的依从性数据可用，评估证据的具体障碍- 基础护理将指导制定干预措施，以消除这些障碍。一旦干预措施 结合成一个质量改进工具，在一系列医院的实施系统测试将 需要评估有效性、可行性、可持续性和普遍性。该项目建议使用一个 学习合作模式，以评估肺癌护理中遵守指南的障碍，并确定 解决方案该提案的最终目标是提高对指南的遵守， 肺癌治疗的变化。通过医院适应性评估和实施 干预措施将导致确定可以指导不同类型医院的共同原则， 提供有效的、遵循指南的肺癌护理。这项工作将导致一个可推广的模式，以评估 癌症护理质量，了解变异的根本原因，提高对国家指南的依从性 并传播循证最佳做法。 候选人，博士奥德尔，是一个委员会认证的普通胸外科医生与临床和研究 关注肺癌的治疗。他的临床培训和先前的研究经验测量结果 评估干预措施，以优化肺癌治疗，并在伊利诺伊州外科质量 改进协作组织（ISQIC）为他提供了独特的建议。奥德尔医生的职业目标是 成为一名独立资助的研究人员，结合先进的定量和定性分析 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 医院为基础的项目。为了实现这一目标，他将需要在此期间的具体额外培训 期间获得3个领域的专业知识：（1）定量评估方法，（2）定性研究方法， （3）实施与传播科学。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目标 教育目标。最后，该项目是我实现职业发展目标的理想工具， 为奥德尔博士提供直接应用定性方法中学到的技能和技术的机会， 定量改进原则，和实施科学，并将他定位为执行持续， 在癌症护理提供方面的创新、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.