A quality improvement program within the research setting to improve cancer clinical trial recruitment, accrual, and retention.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 124-124
Author(s):  
Margo Michaels ◽  
Judith Blanchard ◽  
Kathleen Reims ◽  
Kevin Little ◽  
Gina Pokrashevsky
Keyword(s):  
Clinical Trials ◽  
Quality Improvement ◽  
Best Practices ◽  
Technical Assistance ◽  
Minority Groups ◽  
Lessons Learned ◽  
Trial Participation ◽  
Evidence Based ◽  
Improvement Program ◽  
Menu Selection

124 Background: Participation in and access to cancer treatment clinical trials (CCTs) is a key measure for delivery of quality cancer care. Yet adult trial participation in the U.S. remains under 3%, with even lower participation rates among minority groups and people over 65. There is little evidence for best practices in CCT accrual. If institutions are to be evaluated by the access they provide to CCTs, it is critical to identify practical, evidence-based approaches to maximize the efficiency of CCT recruitment, accrual, and retention efforts. The National Cancer Clinical Trials Pilot Breakthrough Collaborative (NCCTBC) is the first-ever national effort to identify such best practices in a real world setting. Methods: The purpose of this pilot was to test the feasibility of applying a proven quality improvement process to CCT accrual. More than 150 evidence-based changes to processes and procedures were identified. Five community oncology practices designed, tested, and implemented changes and reported monthly on 6 core measures to gauge improvement. Teams collaborated to share challenges and were provided coaching and technical assistance by national experts. Results: Teams have tested 35 changes over a 10-month period. Outcomes from the pilot are already showing promising results in identifying those changes that can have the most impact on improving accrual. For example: Improvements in race and ethnicity data capture are helping to address disparities in patient census. Improvements in processes for trial menu selection are leading to new ways of assessing patient populations and finding trials that match them. Documentation of pre-screening and offer rates is identifying system gaps and ways to increase these rates. Conclusions: Results affirm the feasibility of applying a quality improvement framework to address persistently low accrual rates and decrease health disparities among racial and ethnic minorities and the elderly. Based on lessons learned, we are making improvements to the NCCTBC infrastructure and processes and plan to recruit 10 new teams to test further changes.

scholarly journals Evidence-Based Practice Implementation: Case Report of the Evolution of a Quality Improvement Program in a Multicenter Physical Therapy Organization

2015 ◽  
Vol 95 (4) ◽  
pp. 588-599 ◽  
Author(s):  
Joel M. Stevans ◽  
Christopher G. Bise ◽  
John C. McGee ◽  
Debora L. Miller ◽  
Paul Rockar ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Case Report ◽  
Physical Therapy ◽  
Care Quality ◽  
Routine Practice ◽  
Evidence Based ◽  
Implementation Barriers ◽  
Improvement Program ◽  
Improvement Project ◽  
Systems Perspective

Background and Purpose Our nation's suboptimal health care quality and unsustainable costs can be linked to the failure to implement evidence-based interventions. Implementation is the bridge between the decision to adopt a strategy and its sustained use in practice. The purpose of this case report is threefold: (1) to outline the historical implementation of an evidence-based quality improvement project, (2) to describe the program's future direction using a systems perspective to identify implementation barriers, and (3) to provide implications for the profession as it works toward closing the evidence-to-practice gap. Case Description The University of Pittsburgh Medical Center (UPMC) Centers for Rehab Services is a large, multicenter physical therapy organization. In 2005, they implemented a Low Back Initiative utilizing evidence-based protocols to guide clinical decision making. Outcomes The initial implementation strategy used a multifaceted approach. Formative evaluations were used repeatedly to identify barriers to implementation. Barriers may exist outside the organization, they can be created internally, they may result from personnel, or they may be a direct function of the research evidence. Since the program launch, 3 distinct improvement cycles have been utilized to address identified implementation barriers. Discussion Implementation is an iterative process requiring evaluation, measurement, and refinement. During this period, behavior change is actualized as clinicians become increasingly proficient and committed to their use of new evidence. Successfully incorporating evidence into routine practice requires a systems perspective to account for the complexity of the clinical setting. The value the profession provides can be enhanced by improving the implementation of evidence-based strategies. Achieving this outcome will require a concerted effort in all areas of the profession. New skills will be needed by leaders, researchers, managers, and clinicians.

Evidence-Based Best Practices Collections

2011 ◽  
pp. 280-287 ◽  
Author(s):  
Forrest Shull ◽  
Raimund Feldmann ◽  
Michelle Shaw ◽  
Michelle Lambert
Keyword(s):  
Knowledge Management ◽  
Best Practices ◽  
Competitive Advantage ◽  
Driving Force ◽  
Best Practice ◽  
General Concept ◽  
Lessons Learned ◽  
Evidence Based ◽  
Specific Knowledge ◽  
White Board

For capturing and transferring knowledge between different projects and organizations, the concept of a Best Practice is commonly used. A similar but more general concept for knowledge capturing is often referred to as a Lesson Learned. Both best practices and lessons learned are frequently organized in the form of knowledge collections. Such collections exist in many forms and flavours: From simple notes on a white board, to paper file collections on a shelf, to electronic versions filed in a common folder or shared drive, to systematically archived and standardized versions in experience and databases, or even specific knowledge management systems. In the past few decades, many organizations have invested much time and effort in such specific knowledge collections (e.g., databases, experience repositories) for best practices and/ or lessons learned. The driving force behind all these activities is to disseminate knowledge about proven solutions to their workforce. Ultimately, the goal is to avoid mistakes and improve the overall workflow and processes to possibly save money and gain a competitive advantage.

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