Evidence map›Paper›PMID 24523602›Full record

ArticleCurrent oncology (Toronto, Ont.)2014

Piloting a regional collaborative in cancer surgery using a "community of practice" model.

M Fung-Kee-Fung, R P Boushey, J Watters, R Morash, J Smylie, C Morash, C Degrasse, S Sundaresan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Current oncology (Toronto, Ont.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
4.5field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

M Fung-Kee-FungDepartment of Surgery, University of Ottawa, Ottawa, ON. ; Surgical Oncology Program, Cancer Care Ontario, Toronto, ON.
R P BousheyDepartment of Surgery, University of Ottawa, Ottawa, ON. ; Surgical Oncology Program, Cancer Care Ontario, Toronto, ON.
J WattersDepartment of Surgery, University of Ottawa, Ottawa, ON.
R MorashThe Ottawa Hospital Cancer Program, The Ottawa Hospital, Ottawa, ON.
J SmylieThe Ottawa Hospital Cancer Program, The Ottawa Hospital, Ottawa, ON.
C MorashDepartment of Surgery, University of Ottawa, Ottawa, ON. ; Surgical Oncology Program, Cancer Care Ontario, Toronto, ON.
C DegrasseThe Ottawa Hospital Cancer Program, The Ottawa Hospital, Ottawa, ON.
S SundaresanDepartment of Surgery, University of Ottawa, Ottawa, ON. ; Surgical Oncology Program, Cancer Care Ontario, Toronto, ON.
Ottawa Hospital · CAUniversity of Ottawa · CACancer Care Ontario · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients requiring assessment for cancer surgery encounter a complex series of steps in their cancer journey. Further complicating the process is the fact that care is often delivered in a fragmented, silo-based system. Isolated strategies to improve cancer outcomes within those systems have had inconsistent results.

methodsA regional quality improvement collaborative was developed based on a community of practice (cop) platform, a hub-and-spoke infrastructure, and a regional steering committee linking cop improvement projects with affiliated hospitals and their strategic priorities. The cop provided an avenue for multidisciplinary teams to collect and compare their performance data and to institute regional standards through literature review, discussion, and consensus. Regional interdisciplinary teams developed a set of quality indicators linked to mutually agreed-upon care standards. A limited regional database supported feedback about performance against both provincial and regional standards.

resultsThe cop approach helped to develop a multihospital collaboration that facilitated care quality improvements on a regional scale, with clinical outcomes of the improvements able to be measured. The 9 participating hospitals delivered cancer surgery in the specific disease sites according to practitioner-developed and provincially- or regionally-generated care standards and clinical pathways. Compliance with provincial evidence-based clinical guidelines improved (20% increase in 2010-2011 compared with 2006-2007). Other significant improvements included standardization and implementation of regional perioperative pathways in breast, colorectal, and prostate cancer disease sites; rectal cancer surgery centralization; increased use of sentinel lymph node biopsies in breast cancer surgery; and decreased positive surgical margin rates in prostate cancer.

conclusionsImproved quality is likely a result of diverse confounding factors. The deliberately cultivated multihospital multidisciplinary cops have contributed to positive structural and functional change in cancer surgery in the region. This regional cop model has the potential to play an important role in the development of successful collaborations in care quality improvement.

Indexed as

cancer careCommunity of practicequality improvementregional collaboration

Identifiers

PMID24523602
PMCPMC3921028
OpenAlexW2095334712

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.