Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Radiation Treatment Program, Cancer Care Ontario, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Radiation Treatment Program, Cancer Care Ontario, Ontario, Canada.
Pract Radiat Oncol. 2019 Mar;9(2):e242-e248. doi: 10.1016/j.prro.2018.10.017. Epub 2018 Nov 14.
In 2003 and 2004, Cancer Care Ontario (CCO) divested its assets and staff to regional hospitals, leading to decreased contact between radiation therapy departments across Ontario's Regional Cancer Centres (RCCs). The Radiation Treatment Program (RTP) at CCO developed a communities-of-practice (CoPs) program to rebuild the provincial radiation therapy community to facilitate collaboration among centers, with the goals of decreasing variation in practice and improving the quality of patient care. RTP's CoPs are led and driven by volunteer frontline health care practitioners who identify and prioritize key quality issues and select corresponding projects to pursue.
An evaluation of RTP's CoPs was conducted to assess whether they were successful in knowledge creation, knowledge transfer and exchange, and community building. The framework was developed based on the Centers for Disease Control and Prevention CoP evaluation framework and tools. Data were collected using prospectively administered member surveys (257 surveys), publications, and semistructured interviews (18 participants).
A total of 95% of participants reported that CoP projects were very relevant to their practice, and 50% reported changes in their practice stemming from CoP involvement. In addition, 90% of participants reported growth of their professional network as a result of CoPs. Overall, 93% of participants and 100% of interviewees reported that CoPs are a worthwhile initiative. The largest challenge of CoPs was the time commitment required to participate.
This approach of member-driven CoPs should be explored and modeled in other health care settings as a means to develop and share knowledge to reduce variation in care and improve the quality of radiation therapy care.
2003 年和 2004 年，安大略癌症护理中心（CCO）将其资产和员工转让给区域医院，导致安大略省地区癌症中心（RCC）的放射治疗部门之间的联系减少。CCO 的放射治疗计划（RTP）开发了一个实践社区（CoPs）计划，以重建省级放射治疗社区，促进各中心之间的合作，目标是减少实践中的差异，提高患者护理质量。RTP 的 CoPs 由志愿一线医疗保健从业者领导和推动，他们确定和优先考虑关键质量问题，并选择相应的项目来进行。
对 RTP 的 CoPs 进行了评估，以评估它们在知识创造、知识转移和交流以及社区建设方面是否成功。该框架是基于疾病控制和预防中心 CoP 评估框架和工具制定的。使用前瞻性管理的成员调查（257 份调查）、出版物和半结构化访谈（18 名参与者）收集数据。
共有 95%的参与者报告说 CoP 项目与他们的实践非常相关，50%的参与者报告说 CoP 参与导致他们的实践发生了变化。此外，90%的参与者报告说由于 CoPs，他们的专业网络有所扩大。总体而言，93%的参与者和 100%的受访者表示 CoPs 是一项有价值的举措。CoPs 面临的最大挑战是参与所需的时间承诺。
这种成员驱动的 CoPs 方法应该在其他医疗保健环境中进行探索和建模，作为开发和共享知识以减少护理差异和提高放射治疗护理质量的一种手段。
