ArticleOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2025
Implementation Mapping to Identify Strategies to Increase Timely Postoperative Radiotherapy Initiation for Head/Neck Cancer.
Article in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- A Discharge Summary Prompt Reduces Postoperative Radiotherapy Delay in Head and Neck Cancer Patients.Head & neck · 2026Article
- Barriers and Facilitators to Timely Adjuvant Therapy for Head and Neck Cancer in Rural Care.JAMA otolaryngology-- head & neck surgery · 2026Article
- Barriers and Timely Postoperative Radiation Therapy in Head and Neck Cancer.JAMA otolaryngology-- head & neck surgery · 2025Article
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Authors and funding
12 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTimely initiation of postoperative radiotherapy (PORT) for head and neck squamous cell carcinoma (HNSCC) is associated with improved survival, but rates of timely PORT initiation are low. To support uptake in a tertiary academic center, we aimed to identify implementation determinants (eg, barriers and facilitators) to timely PORT initiation and to design context-specific implementation strategies.
methodsWe created an implementation blueprint through a sequential mixed-methods study where we (1) identified determinants by fielding a 15-item survey based on the Theoretical Domains Framework (TDF), (2) prioritized determinants through focus groups with relevant stakeholders, (3) mapped barriers to implementation strategies using the Consolidated Framework for Implementation Research (CFIR)-Expert Recommendations for Implementing Change (ERIC) matching tool, and (4) operationalized strategies using the Action, Actor, Context, Target, Time (AACTT) framework.
resultsTwenty-three participants from three departments (61% Radiation Oncology, 35% Otolaryngology, 4% Medical Oncology) in a variety of roles (35% physicians, 39% nurses or advanced practice providers, 22% radiation therapists or dosimetrists, and 4% research coordinators) completed surveys. Participants identified 10 determinants affecting timely PORT initiation. After strategy selection and operationalization by focus group participants (n = 13), three ERIC strategies were selected for clinical implementation: remind clinicians, conduct educational meetings, and facilitate relay of clinical data to providers. DISCUSSION: This work developed a menu of implementation strategies for future deployment to support timely PORT initiation. Codesign centered the voice of frontline workers, increasing the likelihood of successful implementation. IMPLICATIONS FOR PRACTICE: The systematic approaches to development can serve as a model for process improvement in other contexts.
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