Implementation of Operative Standards in Cancer Surgery to Improve Patient Outcomes

项目摘要 本NCI K 08职业发展计划的总体目标是促进Ko Un Park博士的发展， 癌症健康服务研究的独立调查员，专注于实施策略， 促进肿瘤外科的循证护理，改善癌症患者的预后。具体来说， 该提案将把实施科学（IS）的见解应用于癌症手术标准的应用， 癌症委员会（Commission on Cancer，CoC）CoC是一个认证组织，旨在提高 通过1500家医院的护理服务标准化为癌症患者提供的治疗结果 为大约70%的美国癌症患者提供治疗。到目前为止，CoC还没有将其标准与 执行战略;因此，标准的执行往往很差。的首要目标 该项目旨在为采用CoC的新乳腺综合征创建由患者驱动的策略， 手术报告（SOR）标准，通过使用IS的工具来识别和解决SOR的障碍和促进因素 在不同的医疗保健系统中实施。为了实现这一目标，在目标1中，我们将对关键利益相关者进行 访谈，以确定实施乳腺SOR的障碍和促进因素。在目标2中，我们将使用 实施决定因素，以设计战略，促进乳腺SOR的实施。我们将测试 战略对关键执行成果的影响（例如，可行性、可接受性）。我们 假设我们将确定SOR实施的外科医生和组织级驱动因素， 利用这一点来建立多层次的实施战略，以改善乳腺癌的结果。的 计划的培训，拟议的研究项目，多学科的导师团队，和特殊的研究 俄亥俄州州立大学综合癌症中心的环境非常适合解决Park博士的问题。 职业目标。她的职业发展计划包括IS的正式课程以及指导性阅读， 两会这种教育和指导的努力，以执行研究建议，帮助博士公园的长期 职业目标是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 促进专业自律政策的实施（即，CoC标准） 健康系统和癌症中心，以及医生之间。通过这次培训，朴博士将能够成功地 为随后的前瞻性多中心试验获得资金，以测试所开发策略的有效性 在拟议的项目中。

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.