A high proportion of head and neck cancer survivors reduced their work capacity and many did not return following cancer treatment. Further research is needed to understand the barriers to work return in these survivors and to explore strategies to encourage resumption of employment and employment satisfaction.

Background Communities of practice (cops) have been shown to be effective models for achieving quality outcomes in health care.Objective Here, we describe the application of the cop model to the Canadian oncology context.Methods We established an oncology cop at our urban community hospital and its networks. Goals were to decrease barriers to access, foster collaboration, and improve knowledge of guidelines in cancer care. We hosted 6 in-person multidisciplinary meetings, focusing on screening, diagnosis, and management of common solid tumours. Health care providers affiliated with our hospital were invited to attend and to complete post-meeting surveys. Likert scales assessed whether cop goals were realized.Results Meetings attracted a mean of 57 attendees (range: 48–65 attendees), with a mean of 84% completing the surveys and consenting to the analysis. Attendees included family physicians (mean: 41%), specialist physicians (mean: 24%), nurses (mean: 10%), and allied health care providers (mean: 22%). Repeat attendance increased during the series, with 85% of attendees at the final meeting having attended 1 or more prior meetings. Across the series, most participants agreed or strongly agreed that the cop reduced barriers (mean: 76.0% ± 7.9%) and improved access to cancer care services (mean: 82.4% ± 8.1%) and subject matter experts (mean: 91.7% ± 4.2%); fostered teamwork (mean: 84.5% ± 6.8%) and a culture of collaboration (mean: 94.8% ± 4.2%); improved knowledge of cancer care services (mean: 93.3% ± 4.8%), standards of practice (mean: 92.3% ± 3.1%), and quality indicators (mean: 77.5% ± 6.3%); and improved cancer-related practice (mean: 88.8% ± 4.6%) and satisfaction in caring for cancer patients (mean: 82.9% ± 6.8%). Participant feedback carried a potential for bias.Conclusions We demonstrated the feasibility of oncology cops and found that participants perceived their value in reducing barriers to access, fostering collaboration, and improving knowledge of guidelines in cancer care.

Background A community of practice (cop) is formally defined as a group of people who share a concern or a passion for something they do and who learn how to do it better as they interact regularly. Communities of practice represent a promising approach for improving cancer care outcomes. However, little research is available to guide the development of oncology cops. In 2015, our urban community hospital launched an oncology cop, with the goals of decreasing barriers to access, fostering collaboration, and improving practitioner knowledge of guidelines and services in cancer care. Here, we share insights from a qualitative analysis of feedback from participants in our cop. The objective of the project was to identify participant perspectives about preferred cop features, with a view to improving the quality of our community hospital’s oncology cop.Methods After 5 in-person meetings of our oncology cop, participants were surveyed about what the cop should start, stop, and continue doing. Qualitative methods were used to analyze the feedback.Results The survey collected 250 comments from 117 unique cop participants, including family physicians, specialist physicians, nurses, and allied health care practitioners. Analysis identified participant perspectives about the key features of the cop and avenues for improvement across four themes: supporting knowledge exchange, identifying and addressing practice gaps, enhancing interprofessional collaboration, and fostering a culture of partnership.Conclusions Based on the results, we identified several considerations that could be helpful in improving our cop. Our findings might help guide the development of oncology cops at other institutions.

Cancer survivors have strong personal desires to resume work to feel productive and meet financial needs. However, they may be faced with physical and psychological challenges. This research aims to: examine cancer survivors' perspectives on supports needed when returning to work; investigate sex and gender differences when returning to work; and explore demographic and employment factors that may influence this process. An exploratory qualitative design was used. The study had two phases: focus groups and one-on-one semi-structured interviews. Inductive thematic analysis was used to analyze the data. The total sample includes 15 participants, 87% female and 13% male. Key themes include: changing perspectives on self and work; managing work and social systems; determining disclosure and accommodation; and the importance of supports for return to work and daily life. This study informs cancer rehabilitation research by developing an understanding of the supports needed to help cancer survivors return to work successfully. Chapter 1: Introduction Purpose of Study In 2017, the Canadian Cancer Society released a report stating that about 1 in 2 Canadians are expected to be diagnosed with cancer in their lifetime (Canadian Cancer Society, 2017). Furthermore, it predicts that nearly 55% of all new cases of cancer will occur in people aged 20-69 years (Canadian Cancer Society, 2017). Given that working age is normally defined as 15 to 64 (Organisation for Economic Cooperation and Development [OECD], 2017), most Canadians who are diagnosed with cancer are likely to be interested in returning to or staying at work as a way to establish normality, social relationships, and enhance quality of life (Peteet, 2000; Steiner, Cavender, Main, & Bradley, 2004). In fact, a literature review by Spelten, Sprangers, and Verbeek (2002) found that, on average, 62% of cancer survivors are able to stay at work or return to work after treatment. Another cohort study found that this number increases to 85% after 4 years, confirming that many cancer survivors are able to remain or stay at work after treatment (Short, Vasey, & Tunceli, 2005). Cancer impacts not only individuals, but also stakeholders throughout the healthcare system and in the workplace (Maunsell,