确定稳健的生存项目实施策略：癌症项目的定性分析。
Identifying Strategies for Robust Survivorship Program Implementation: A Qualitative Analysis of Cancer Programs.
机构信息
Health Policy and Management, University of North Carolina Chapel Hill, Chapel Hill, NC.
Health Policy and Management/Kenan-Flagler Business School, University of North Carolina at Chapel Hill, Chapel Hill, NC.
出版信息
JCO Oncol Pract. 2022 Mar;18(3):e304-e312. doi: 10.1200/OP.21.00357. Epub 2021 Oct 4.
PURPOSE
The Commission on Cancer seeks to promote robust survivorship programs among accredited cancer programs. In practice, cancer programs' survivorship programs range from cursory (eg, developing care plans without robust services) to robust (eg, facilitating follow-up care). To inform cancer programs' future efforts, in this study, we identified the implementation strategies that cancer programs used to achieve robust survivorship programs, distinguishing them from cursory programs.
METHODS
We sampled 39 cancer programs across the United States with approaches to survivorship program implementation ranging from cursory to robust on the basis of LIVESTRONG survivorship care consensus elements. Within sampled cancer programs, we conducted in-depth semistructured interviews with a total of 42 health care professionals. We used template analysis to distinguish implementation strategies used in cancer programs with robust survivorship programs from strategies that yielded cursory survivorship programs.
RESULTS
Cancer programs with robust survivorship programs established clear systems survivorship care and formal committees to improve the survivorship care processes. They sought buy-in from multiple stakeholders to leverage cancer program resources and defined clear roles with shared accountability among multidisciplinary groups. By contrast, cancer programs with cursory survivorship programs reported less consistency in survivorship care processes and lacked buy-in from key stakeholders. They had limited resources, faced persistent structural concerns, and had insufficient clarity in roles among team members.
CONCLUSION
Accrediting bodies may consider incorporating the implementation strategies that robust survivorship programs have used as guidance for supporting cancer programs in operationalizing survivorship care and evaluating the use of these strategies during the accreditation and review process.
目的
癌症委员会旨在促进认证癌症项目中强有力的生存项目。在实践中，癌症项目的生存项目范围从粗略（例如，制定护理计划但没有提供强有力的服务）到完善（例如，促进后续护理）。为了告知癌症项目未来的努力，在这项研究中，我们确定了癌症项目用于实现完善生存项目的实施策略，将其与粗略项目区分开来。
方法
我们在美国范围内抽取了 39 个癌症项目，这些项目在生存项目实施方法上从粗略到完善，基于 LIVESTRONG 生存护理共识要素。在抽样的癌症项目中，我们总共对 42 名医疗保健专业人员进行了深入的半结构化访谈。我们使用模板分析来区分在完善的生存项目中使用的实施策略和产生粗略生存项目的策略。
结果
完善生存项目的癌症项目建立了明确的系统生存护理和正式委员会，以改善生存护理流程。他们寻求多方利益相关者的认可，利用癌症项目资源，并在多学科团队之间定义明确的角色，共同承担责任。相比之下，生存项目粗略的癌症项目报告说，生存护理流程的一致性较差，关键利益相关者缺乏认可。他们的资源有限，面临持续的结构性问题，团队成员之间的角色也不够明确。
结论
认证机构可以考虑纳入完善生存项目所使用的实施策略，作为支持癌症项目实施生存护理和在认证和审查过程中评估这些策略使用的指导。
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