Improving Rectal Cancer Surgery Through Regional Collaboration

描述（由申请人提供）：在癌症类型的范围内，结果研究表明，美国癌症护理的质量各不相同。了解这种变化，更重要的是，如何纠正它是癌症健康服务研究的未来方向。该提案旨在了解和解决循证癌症治疗的障碍，同时为职业发展候选人提供非常丰富的研究培训和指导经验。这项研究计划特别关注直肠癌的手术护理质量，每年有超过4万名美国人被诊断出患有直肠癌。有强有力的证据表明，采用循证外科治疗可改善该病的预后。然而，在直肠癌的循证实践和治疗结果的使用上存在差异，这表明有机会提高护理质量。该提案的研究目标包括(1)在现有手术质量改进组织的背景下，评估医院对直肠癌循证实践的依从性；(2)定性评估采用循证实践的障碍；(3)设计和评估一项干预措施，以增加循证实践的使用。这个项目，多学科的指导团队，和研究环境非常适合解决候选人的职业目标和教育需求，萨曼莎亨德伦，医学博士，公共卫生硕士。Hendren博士是一名委员会认证的结直肠外科医生，对结直肠肿瘤有临床和研究兴趣。她之前在测量癌症结果和干预措施以优化癌症护理方面的研究经验为她的这项提议做好了准备。然而，为了实现她的职业目标，通过以医院为基础的质量改进项目来改善结直肠癌的治疗，她将需要额外的培训。教育目标，包括获得实施科学方面的专业知识，比较医院绩效的先进统计方法，以及合作项目的组织，在赠款的教育计划和高度成就的指导团队下是可行的。教育项目包括研究生水平的定性方法、分层建模和健康交流课程，以及前往卓越中心和相关的国家会议。总之，该研究项目、导师团队和教育计划将为Hendren博士开展持续的、创新的、独立的研究以改善结直肠癌的治疗和结果奠定基础。

DESCRIPTION (provided by applicant): Across the spectrum of cancer types, outcomes research has demonstrated that the quality of cancer care varies in the United States (US). Understanding this variation and, more importantly, how to correct it is the future direction for cancer health services research. This proposal seeks to understand and address the barriers to evidence-based cancer care while providing the career development candidate with a very rich research training and mentorship experience. The research proposal focuses specifically on the quality of surgical care for rectal cancer, which is diagnosed in more than 40,000 Americans each year. There is strong evidence linking the use of evidence-based surgical practices with improved outcomes for this disease. However, variation in the use of evidence-based practices and treatment outcomes for rectal cancer has been demonstrated, suggesting opportunities to improve the quality of care. The proposal's research aims include (1) assessing hospitals' compliance with evidence-based practices for rectal cancer, within the setting of an existing surgical quality-improvement organization; (2) qualitatively assessing barriers to uptake of evidence- based practices; and (3) designing and evaluating an intervention to increase use of evidence-based practices. This project, the multidisciplinary mentorship team, and the research environment are ideally suited to address the career goals and educational needs of the candidate, Samantha Hendren, MD, MPH. Dr. Hendren is a board-certified colorectal surgeon with a clinical and research interest in colorectal neoplasms. Her prior research experience with measuring cancer outcomes and interventions to optimize cancer care has prepared her for this proposal. However, to achieve her career goal of improving colorectal cancer care through hospital-based quality-improvement programs, she will need additional training. Educational goals, including obtaining expertise in implementation science, advanced statistical methods for comparing hospital performance, and organization of collaborative programs, are feasible with the grant's educational plan and highly accomplished mentorship team. The educational program includes graduate-level courses in qualitative methods, hierarchical modeling, and health communications, as well as travel to centers of excellence and relevant national conferences. In summary, this research project, mentor team, and educational plan will lay the groundwork for Dr. Hendren to perform ongoing, innovative, independent research to improve colorectal cancer treatment and outcomes.