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Development of communities of practice to facilitate quality improvement initiatives in surgical oncology.
Qual Manag Health Care. 2008 Apr-Jun;17(2):174-85
Publication Type
Michael Fung-Kee-Fung
Elena Goubanova
Karen Sequeira
Arifa Abdulla
Rose Cook
Claire Crossley
Bernard Langer
Andrew J Smith
Hartley Stern
Author Affiliation
Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
Qual Manag Health Care. 2008 Apr-Jun;17(2):174-85
Publication Type
Models, organizational
Oncology Service, Hospital - standards
Organizational Case Studies
Quality Assurance, Health Care - organization & administration
Surgery Department, Hospital - standards
The process of developing clinical guidelines and standards for cancer treatment and screening is well established in the Ontario health care system; however, the dissemination and implementation of such guidelines and standards are more recent undertakings. Traditional implementation strategies to improve surgical practice and the delivery of cancer care have not been consistently effective. There is a recognized need to develop integrated models that offer direct support for implementation strategies. Such a model should be feasible, adaptable, and open to evaluation across diverse surgical settings.
Research suggests that successful implementation should consider tools and expertise from other disciplines. This article considers a community of practice (COP) model to provide a supportive infrastructure for quality improvements in cancer surgery. The COP model was adapted for cancer surgeons. It is supported by 5 enablers referred to as tools: communication system, project development support, access to data, access to evidence review, and accreditation with continued medical education and continued professional development. These tools need to be part of an infrastructure that is both provided and supported by a team of administrators and health care professionals, who have active roles and responsibilities. Therefore, the primary objective of this article is to describe our COP model in cancer surgery including the key success factors necessary for providing the infrastructure and tools. The secondary objective is to offer the integrated COP model as a basis for future research and the evaluation of various collaborative improvement projects.
Building on knowledge management concepts, we identified the 4 essential processes that should be targeted by implementation strategies. A common COP evaluation framework uses the outcomes of 4 knowledge conversion modes-organizational memory, social capital, innovation, and knowledge transfer-as proxies for actual provider and organizational behavior. Insights from different collaborative improvement projects described in a consistent way could inform future research and assist in the collation of systematic reviews on this topic.
PubMed ID
18425031 View in PubMed
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