Barriers to high-quality rectal cancer care: A qualitative study - 20/06/22
, Arielle E. Kanters a, Arden M. Morris b, Zaid M. Abdelsattar c, Robert Rico Berry a, Ken Resnicow d, Nancy J. Birkmeyer eAbstract |
Background |
High quality multidisciplinary care improves outcomes for rectal cancer (RC) but is not consistently provided. Our objective was to understand surgeons’ barriers to RC care.
Methods |
Semi-structured interviews were conducted with 18 surgeons from 10 Michigan hospitals. Reports of hospital performance were shared. Interview transcripts were dual coded; data were reduced into emergent themes; and disagreements were resolved by discussion.
Results |
Barriers to high quality care included negative attitudes, (resistance to change; not taking responsibility) lack of training/experience, complex care coordination, and financial disincentives. Facilitators included providers’ positive attitudes and relationships, training/experience, surgeon leadership (development of protocols), patient-level systems of care (patient navigator), and higher-level support (cancer center reviews quality data). Themes were incorporated into an explanatory framework, with patient, provider, and systems domains.
Conclusions |
In this qualitative study of RC surgeons, we identified barriers to and facilitators of high-quality care. The framework developed will facilitate the design of quality improvement interventions.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | This qualitative study examined surgeons' perspectives on rectal cancer care. |
• | Barriers to care included attitudes, training, coordinating care, and financial. |
• | Facilitators included attitudes, surgeon leadership, systems of care. |
• | Our framework will help in designing quality improvement interventions. |
Keywords : Rectal neoplasms, Quality improvement, Delivery of healthcare, Practice patterns, Physicians'
Plan
Vol 224 - N° 1PB
P. 483-488 - juillet 2022 Retour au numéro
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