KanSurvive: Testing a model for improving cancer survivorship care in rural practice

KanSurvive：测试在农村实践中改善癌症生存护理的模型

基本信息

批准号：
10473532
负责人：
K ALLEN GREINER
金额：
$ 44.37万
依托单位：
UNIVERSITY OF KANSAS MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-23 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10473532
关键词：
Acute Address Adoption Awareness Breast Breast Cancer survivor Cancer Survivor Cancer Survivorship Caring Case Based Learning Chronic Clinic Colorectal Colorectal Cancer Community Healthcare Community of Practice Development Diagnosis Documentation Dose Educational Curriculum Electronic Health Record Evaluation Evidence based practice Focus Groups Guidelines Infrastructure Intervention Kansas Knowledge Lead Left Longevity Lung Malignant Neoplasms Malignant neoplasm of lung Malignant neoplasm of prostate Measures Mentors Modeling Observational Study Oncology Participant Persons Phase Primary Health Care Process Promoting Action on Research Implementation in Health Services framework Provider Psychological reinforcement Quality of Care Randomized Reporting Research Personnel Resources Risk Rural Ships Specialist Structure Survivors System Testing Time Training Update Work acceptability and feasibility acute care base cancer care cancer risk cancer therapy care outcomes care providers case-based effectiveness evaluation effectiveness testing end of life evidence base evidence based guidelines follow-up implementation barriers implementation facilitators implementation science improved innovation interest malignant breast neoplasm model development novel peer prevent programs prostate cancer survivors recruit survivorship

项目摘要

ABSTRACT Cancer survivors in the acute and extended phases of care would benefit from improvements in the quality and coordination of primary and cancer care they receive. Cancer researchers have left the management of rural cancer survivors largely unstudied. While evidence-based practice guidelines exist, implementation in rural primary care practices has fallen short. Studies have yet to fully identify the barriers preventing successful implementation of guidelines in these settings. Opportunities exist to improve the understanding of both the reasons why cancer survivorship care is sub optimal in rural primary care as well as to test mechanisms for helping practices implement systems that assure all cancer survivors can be identified and are receiving guideline concordant care. This study sets out to evaluate current practices in managing rural cancer survivors and test a KanSurvive Project ECHO intervention to transform practices for delivery of evidence-based survivorship care. The primary aims are to 1) describe gaps in care, infrastructure needs and processes of care for acute and chronic cancer survivorship in rural primary care clinics focusing on rural breast, colorectal, lung, and prostate cancer survivors while finalizing the KanSurvive Project ECHO intervention; 2) evaluate the effectiveness of practice facilitation integrated with telementoring program for enhancing adoption of evidence- based practice guidelines for breast, colorectal, lung, and prostate survivors; and 3) describe key facilitators and barriers to implementation of KanSurvive Project ECHO and evidence of related EHR documentation change in these practices. This novel project will provide a model for use of implementation science and the development of a “community of practices” working together to improve rural cancer survivorship care from diagnosis to the end-of-life.

抽象的急性期和长期护理阶段的癌症幸存者将受益于护理质量和护理质量的提高。癌症研究人员已经离开了农村的管理部门。虽然存在基于证据的实践指南，但在农村的实施情况却基本上没有得到研究。初级保健实践还不够充分，研究尚未完全确定阻碍成功的障碍。在这些环境中实施指南是有机会增进对两者的理解的。农村初级保健中癌症生存护理未达到最佳状态的原因以及测试机制帮助实践实施确保所有癌症幸存者都能被识别并接受治疗的系统本研究旨在评估当前管理农村癌症幸存者的做法。并测试 KanSurvive 项目 ECHO 干预措施，以改变提供基于证据的实践主要目标是 1) 描述护理、基础设施需求和流程方面的差距。农村初级保健诊所的急性和慢性癌症生存护理，重点关注农村乳腺癌、结直肠癌、肺癌和前列腺癌幸存者，同时完成 KanSurvive 项目 ECHO 干预措施；实践促进与远程指导计划相结合以促进证据的采用的有效性乳腺癌、结直肠癌、肺癌和前列腺幸存者的实践指南，以及 3) 描述关键促进者； KanSurvive 项目 ECHO 的实施和 EHR 文档相关障碍的证据这个新颖的项目将为使用实施科学和技术提供一个模型。发展“实践社区”，共同努力改善农村癌症幸存者护理诊断直至生命终结。