Evidence map›Paper›PMID 36443554›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2023

Barriers and Facilitators in Implementation of an Esophagectomy Care Pathway: a Qualitative Analysis.

Helen J Madsen, Anne Lambert-Kerzner, Ellison Mucharsky, Anna K Gergen, Adam R Dyas, Martin McCarter, Camille Stewart, Akshay Pratap, John Mitchell, Simran Randhawa and 1 more

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

11 authors.

Helen J MadsenSurgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA. Helen.madsen@CUAnschutz.edu.ORCID 0000-0002-0954-1052
Anne Lambert-KerznerSurgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Ellison MucharskySurgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Anna K GergenDepartment of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Adam R DyasDepartment of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Martin McCarterDepartment of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, Aurora, CO, USA.
Camille StewartDepartment of Surgery, Division of Surgical Oncology, University of Colorado School of Medicine, Aurora, CO, USA.
Akshay PratapDepartment of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
John MitchellDepartment of Surgery, Division of Thoracic Surgery, University of Colorado, Aurora, CO, USA.
Simran RandhawaDepartment of Surgery, Division of Thoracic Surgery, University of Colorado, Aurora, CO, USA.
Robert A MeguidSurgical Outcomes and Applied Research Program, Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA new postoperative esophagectomy care pathway was recently implemented at our institution. Practice pattern change among provider teams can prove challenging; therefore, we sought to study the barriers and facilitators toward pathway implementation at the provider level.

methodsThis qualitative study was guided by the Theoretical Domains Framework (TDF) to study the adoption and implementation of a post-esophagectomy care pathway. Sixteen in-depth interviews were conducted with providers involved with the pathway. Matrix analysis was used to analyze the data.

resultsProviders included attending surgeons (n = 6), advanced practice providers (n = 8), registered dietitian (n = 1), and clinic staff (n = 1). TDF domains that were salient across our findings included knowledge, beliefs about consequences, social influences, and environmental context and resources. Identified facilitators included were electronic health record tools, such as note templates including pathway components and a pathway-specific order set, patient satisfaction, and preliminary data indicating clinical benefits such as a reduced anastomotic leak rate. The major barrier reported was a hesitance to abandon previous practice patterns, most prevalent at the attending surgeon level.

conclusionThe TDF enabled us to identify and understand the individuals' perceived barriers and facilitators toward adoption and implementation of a postoperative esophagectomy pathway. This analysis can help guide and improve adoption of surgical patient care pathways among providers.

Indexed as

Critical PathwaysEsophagectomyHumansPatient SatisfactionQualitative ResearchEsophagectomyImplementationPostoperative pathwayQualitative study

Identifiers

PMID36443554
PMCPMC9707093

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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.