What is multidisciplinary cancer care like in practice? a protocol for a mixed-method study to characterise ambulatory oncology services in the Australian public sector
Introduction An understanding of the real-world provision of oncology outpatient services can help maintain service quality in the face of escalating demand and tight budgets, by informing the design of interventions that improve the effectiveness or efficiency of provision. The aims of this study a...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/9/10/e031179.full |
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| author | David C Currow Jonathan Karnon Jeffrey Braithwaite Yvonne Tran Mia Bierbaum Johanna Westbrook Gaston Arnolda Robyn L Ward Ian Olver Bróna Nic Giolla Easpaig Klay Lamprell Geoffrey P Delaney Winston Liauw Renuka Chittajallu Teresa Winata |
| author_facet | David C Currow Jonathan Karnon Jeffrey Braithwaite Yvonne Tran Mia Bierbaum Johanna Westbrook Gaston Arnolda Robyn L Ward Ian Olver Bróna Nic Giolla Easpaig Klay Lamprell Geoffrey P Delaney Winston Liauw Renuka Chittajallu Teresa Winata |
| author_sort | David C Currow |
| collection | DOAJ |
| description | Introduction An understanding of the real-world provision of oncology outpatient services can help maintain service quality in the face of escalating demand and tight budgets, by informing the design of interventions that improve the effectiveness or efficiency of provision. The aims of this study are threefold. First, to develop an understanding of cancer services in outpatient clinics by characterising the organisation and practice of multidisciplinary care (MDC). Second, to explore the key areas of: (a) clinical decision-making and (b) engagement with patients’ supportive needs. Third, to identify barriers to, and facilitators of, the delivery of quality care in these settings.Methods and analysis A suite of mixed-methods studies will be implemented at six hospitals providing cancer outpatient clinics, with a staged roll-out. In Stage One, we will examine policies, use unstructured observations and undertake interviews with key health professionals to characterise the organisation and delivery of MDC. In Stage Two, observations of practice will continue, to deepen our understanding, and to inform two focused studies. The first will explore decision-making practices and the second will examine how staff engage with patients’ needs; both studies involve interviews, to complement observation. As part of the study of supportive care, we will examine the implications of an introduction of patient-reported measures (PRMs) into care, adding surveys to interviews before and after PRMs roll-out. Data analysis will account for site-specific and cross-site issues using an adapted Qualitative Rapid Appraisal, Rigorous Analysis approach. Quantitative data from clinician surveys will be statistically analysed and triangulated with the related qualitative study findings.Ethics and dissemination Ethical approval was granted by South Eastern Sydney Local Health District Human Research Ethics Committee (no. 18/207). Findings will be shared with participating hospitals and widely disseminated through publications and presentations. |
| format | Article |
| id | doaj-art-2211b7bec6e2496482d221bc20c054b7 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2019-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2211b7bec6e2496482d221bc20c054b72025-08-20T01:55:42ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-031179What is multidisciplinary cancer care like in practice? a protocol for a mixed-method study to characterise ambulatory oncology services in the Australian public sectorDavid C Currow0Jonathan Karnon1Jeffrey Braithwaite2Yvonne Tran3Mia Bierbaum4Johanna Westbrook5Gaston Arnolda6Robyn L Ward7Ian Olver8Bróna Nic Giolla Easpaig9Klay Lamprell10Geoffrey P Delaney11Winston Liauw12Renuka Chittajallu13Teresa Winata14Faculty of Science Medicine and Health, The University of Wollongong, Wollongong, New South Wales, AustraliaFlinders University of South Australia, Adelaide, South Australia, Australia5 Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, AustraliaCentre for Healthcare Resilience and Implementation Science, Macquarie University, Sydney, New South Wales, AustraliaAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australiaprofessor1 Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia6 Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, AustraliaSchool of Psychology, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia1 Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, AustraliaCentre for Healthcare Resilience and Implementation (CHRIS), Macquarie University Faculty of Medicine and Health Sciences, Sydney, New South Wales, AustraliaCentre for Research Excellence in Implementation Science in Oncology, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, AustraliaSt George Cancer Centre, Saint George Hospital, Kogarah, New South Wales, AustraliaCentre for Healthcare Resilience and Implementation (CHRIS), Macquarie University Faculty of Medicine and Health Sciences, Sydney, New South Wales, Australia1 Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, AustraliaIntroduction An understanding of the real-world provision of oncology outpatient services can help maintain service quality in the face of escalating demand and tight budgets, by informing the design of interventions that improve the effectiveness or efficiency of provision. The aims of this study are threefold. First, to develop an understanding of cancer services in outpatient clinics by characterising the organisation and practice of multidisciplinary care (MDC). Second, to explore the key areas of: (a) clinical decision-making and (b) engagement with patients’ supportive needs. Third, to identify barriers to, and facilitators of, the delivery of quality care in these settings.Methods and analysis A suite of mixed-methods studies will be implemented at six hospitals providing cancer outpatient clinics, with a staged roll-out. In Stage One, we will examine policies, use unstructured observations and undertake interviews with key health professionals to characterise the organisation and delivery of MDC. In Stage Two, observations of practice will continue, to deepen our understanding, and to inform two focused studies. The first will explore decision-making practices and the second will examine how staff engage with patients’ needs; both studies involve interviews, to complement observation. As part of the study of supportive care, we will examine the implications of an introduction of patient-reported measures (PRMs) into care, adding surveys to interviews before and after PRMs roll-out. Data analysis will account for site-specific and cross-site issues using an adapted Qualitative Rapid Appraisal, Rigorous Analysis approach. Quantitative data from clinician surveys will be statistically analysed and triangulated with the related qualitative study findings.Ethics and dissemination Ethical approval was granted by South Eastern Sydney Local Health District Human Research Ethics Committee (no. 18/207). Findings will be shared with participating hospitals and widely disseminated through publications and presentations.https://bmjopen.bmj.com/content/9/10/e031179.full |
| spellingShingle | David C Currow Jonathan Karnon Jeffrey Braithwaite Yvonne Tran Mia Bierbaum Johanna Westbrook Gaston Arnolda Robyn L Ward Ian Olver Bróna Nic Giolla Easpaig Klay Lamprell Geoffrey P Delaney Winston Liauw Renuka Chittajallu Teresa Winata What is multidisciplinary cancer care like in practice? a protocol for a mixed-method study to characterise ambulatory oncology services in the Australian public sector BMJ Open |
| title | What is multidisciplinary cancer care like in practice? a protocol for a mixed-method study to characterise ambulatory oncology services in the Australian public sector |
| title_full | What is multidisciplinary cancer care like in practice? a protocol for a mixed-method study to characterise ambulatory oncology services in the Australian public sector |
| title_fullStr | What is multidisciplinary cancer care like in practice? a protocol for a mixed-method study to characterise ambulatory oncology services in the Australian public sector |
| title_full_unstemmed | What is multidisciplinary cancer care like in practice? a protocol for a mixed-method study to characterise ambulatory oncology services in the Australian public sector |
| title_short | What is multidisciplinary cancer care like in practice? a protocol for a mixed-method study to characterise ambulatory oncology services in the Australian public sector |
| title_sort | what is multidisciplinary cancer care like in practice a protocol for a mixed method study to characterise ambulatory oncology services in the australian public sector |
| url | https://bmjopen.bmj.com/content/9/10/e031179.full |
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