Journal article
Identifying Core Functions of an Evidence-Based Intervention to Improve Cancer Care Quality in Rural Hospitals
Frontiers in Health Services, Vol.2, 891574
04/28/2022
DOI: 10.3389/frhs.2022.891574
PMCID: PMC9524475
PMID: 36188431
Abstract
Background
Rural patients experience worse cancer survival outcomes than urban patients despite similar incidence rates, due in part to significant barriers to accessing quality cancer care. Community hospitals in non-metropolitan/rural areas play a crucial role in providing care to patients who desire and are able to receive care locally. However, rural community hospitals typically face challenges to providing comprehensive care due to lack of resources. The University of Kentucky's Markey Cancer Center Affiliate Network (MCCAN) is an effective complex, multi-level intervention, improving cancer care in rural/under-resourced hospitals by supporting them in achieving American College of Surgeons Commission on Cancer (CoC) standards. With the long-term goal of adapting MCCAN for other rural contexts, we aimed to identify MCCAN's core functions (i.e., the components key to the intervention's effectiveness/implementation) using theory-driven qualitative data research methods.
Methods
We conducted eight semi-structured virtual interviews with administrators, coordinators, clinicians, and certified tumor registrars from five MCCAN affiliate hospitals that were not CoC-accredited prior to joining MCCAN. Study team members coded interview transcripts and identified themes related to how MCCAN engaged affiliate sites in improving care quality (intervention functions) and implementing CoC standards (implementation functions) and analyzed themes to identify core functions. We then mapped core functions onto existing theories of change and presented the functions to MCCAN leadership to confirm validity and completeness of the functions.
Results
Intervention core functions included: providing expertise and templates for achieving accreditation, establishing a culture of quality-improvement among affiliates, and fostering a shared goal of quality care. Implementation core functions included: fostering a sense of community and partnership, building trust between affiliates and Markey, providing information and resources to increase feasibility and acceptability of meeting CoC standards, and mentoring and empowering administrators and clinicians to champion implementation.
Conclusion
The MCCAN intervention presents a more equitable strategy of extending the resources and expertise of large cancer centers to assist smaller community hospitals in achieving evidence-based standards for cancer care. Using rigorous qualitative methods, we distilled this intervention into its core functions, positioning us (and others) to adapt the MCCAN intervention to address cancer disparities in other rural contexts.
Details
- Title: Subtitle
- Identifying Core Functions of an Evidence-Based Intervention to Improve Cancer Care Quality in Rural Hospitals
- Creators
- Madison M. Wahlen - University of IowaMary C. Schroeder - University of IowaErin C. Johnson - University of IowaIngrid M. Lizarraga - University of IowaJacklyn M. Engelbart - University of Iowa Hospitals and ClinicsDavid J. Tatman - University of IowaCheyenne Wagi - Wake Forest UniversityMary E. Charlton - University of IowaSarah A. Birken - Wake Forest University
- Resource Type
- Journal article
- Publication Details
- Frontiers in Health Services, Vol.2, 891574
- DOI
- 10.3389/frhs.2022.891574
- PMID
- 36188431
- PMCID
- PMC9524475
- NLM abbreviation
- Front Health Serv
- ISSN
- 2813-0146
- eISSN
- 2813-0146
- Language
- English
- Date published
- 04/28/2022
- Academic Unit
- Management and Entrepreneurship ; Epidemiology; Surgery; Pharmacy Practice and Science; Interdisciplinary Programs
- Record Identifier
- 9984274823602771
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