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Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care
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نویسنده
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O’Malley Denalee ,Hudson Shawna V. ,Nekhlyudov Larissa ,Howard Jenna ,Rubinstein Ellen ,Lee Heather S. ,Overholser Linda S. ,Shaw Amy ,Givens Sarah ,Burton Jay S. ,Grunfeld Eva ,Parry Carly ,Crabtree Benjamin F.
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منبع
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journal of cancer survivorship - 2017 - دوره : 11 - شماره : 1 - صفحه:13 -23
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چکیده
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This study describes the experiences of early implementers of primary care-focused cancer survivorship delivery models. snowball sampling was used to identify innovators. twelve participants (five cancer survivorship primary care innovators and seven content experts) attended a working conference focused on cancer survivorship population strategies and primary care transformation. data included meeting discussion transcripts/field notes, transcribed in-depth innovator interviews, and innovators’ summaries of care models. we used a multistep immersion/crystallization analytic approach, guided by a primary care organizational change model. innovative practice models included: (1) a consultative model in a primary care setting; (2) a primary care physician (pcp)-led, blended consultative/panel-based model in an oncology setting; (3) an oncology nurse navigator in a primary care practice; and (4) two subspecialty models where pcps in a general medical practice dedicated part of their patient panel to cancer survivors. implementation challenges included (1) lack of key stakeholder buy-in; (2) practice resources allocated to competing (non-survivorship) change efforts; and (3) competition with higher priority initiatives incentivized by payers. cancer survivorship delivery models are potentially feasible in primary care; however, significant barriers to widespread implementation exist. implementation efforts would benefit from increasing the awareness and potential value-add of primary care-focused strategies to address survivors’ needs. current models of primary care-based cancer survivorship care not be sustainable. innovative strategies to provide quality care to this growing population of survivors need to be developed and integrated into primary care settings.
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کلیدواژه
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Cancer survivorship models ,Primary care ,Implementation research ,Qualitative ,Integration of care
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آدرس
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The State University of New Jersey, USA. Rutgers Biomedical and Health Sciences, USA. Rutgers Robert Wood Johnson Medical School, USA. School of Social Work, USA, The State University of New Jersey, USA. Rutgers Biomedical and Health Sciences, USA. Rutgers Robert Wood Johnson Medical School, USA. Rutgers Cancer Institute of New Jersey, USA, Harvard Medical School, Department of Population Medicine, USA, The State University of New Jersey, USA. Rutgers Biomedical and Health Sciences, USA. Rutgers Robert Wood Johnson Medical School, USA, The State University of New Jersey, USA. Rutgers Biomedical and Health Sciences, USA. Rutgers Robert Wood Johnson Medical School, USA, The State University of New Jersey, USA. Rutgers Biomedical and Health Sciences, USA. Rutgers Robert Wood Johnson Medical School, USA, University of Colorado, Department of General Internal Medicine, USA, Annadel Medical Group, USA, North Perth Family Health, Canada, Springfield Medical Associates, USA, University of Toronto, Canada. Ontario Institute for Cancer Research, Canada, Patient-Centered Outcomes Research Institute (PCORI), USA, The State University of New Jersey, USA. Rutgers Biomedical and Health Sciences, USA. Rutgers Robert Wood Johnson Medical School, USA. Rutgers Cancer Institute of New Jersey, USA
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Authors
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