Provider-Based Research Networks Demonstrate Greater Hospice Use for Minority Patients With Lung Cancer

Penn, Dolly C.; Stitzenberg, Karyn B.; Cobran, Ewan K.; Godley, Paul A.

doi:10.1200/jop.2013.001268

Cited by 7 publications

(3 citation statements)

References 37 publications

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“…PBRNs are a recently emerging approach in public health settings with growing utility [ 26 – 29 ]. Increased research related capacity of PBRNs to enhance services [ 30 ] and improve data and surveillance [ 31 ] has also been demonstrated with clinical practice PBRNs. The use of PBRNs to support quality improvement in local public health agencies is an example of enhanced research related capacity to improve services, albeit not research in itself.…”

Section: Methodsmentioning

confidence: 99%

Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture

Livingood

Peden

Shah

et al. 2015

BMC Health Serv Res

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BackgroundPublic health agencies in the USA are increasingly challenged to adopt Quality Improvement (QI) strategies to enhance performance. Many of the functional and structural barriers to effective use of QI can be found in the organizational culture of public health agencies. The purpose of this study was to assess the impact of public health practice based research network (PBRN) evaluation and technical assistance for QI interventions on the organizational culture of public health agencies in Georgia, USA.MethodsAn online survey of key informants in Georgia’s districts and county health departments was used to compare perceptions of characteristics of organizational QI culture between PBRN supported QI districts and non-PBRN supported districts before and after the QI interventions. The primary outcomes of concern were number and percentage of reported increases in characteristics of QI culture as measured by key informant responses to items assessing organizational QI practices from a validated instrument on QI Collaboratives. Survey results were analyzed using Multi-level Mixed Effects Logistic Model, which accounts for clustering/nesting.ResultsIncreases in QI organizational culture were consistent for all 10- items on a QI organizational culture survey related to: leadership support, use of data, on-going QI, and team collaboration. Statistically significant odds ratios were calculated for differences in increased QI organizational culture between PBRN-QI supported districts compared to Non-PBRN supported districts for 5 of the 10 items, after adjusting for District clustering of county health departments.ConclusionsAgency culture, considered by many QI experts as the main goal of QI, is different than use of specific QI methods, such as Plan-Do-Study-Act (PDSA) cycles or root-cause analyses. The specific use of a QI method does not necessarily reflect culture change. Attempts to measure QI culture are newly emerging. This study documented significant improvements in characteristics of organizational culture and demonstrated the potential of PBRNs to support agency QI activities.

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Section: Methodsmentioning

confidence: 99%

Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture

Livingood

Peden

Shah

et al. 2015

BMC Health Serv Res

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“…Networks may offset these barriers by creating administrative links and referral access, as well as access to expert advice. In fact, research has shown that community practices affiliated with a medical school or cancer research network provide better access to evidence-based care than non-affiliated centers [26][27][28]. This includes better access to treatments and clinical trials [26,29,30].…”

Section: Introductionmentioning

confidence: 99%

Tracing the potential of networks to improve community cancer care: an in-depth single case study

Ridgeway

Boardman

Griffin

et al. 2021

Implement Sci Commun

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Background Despite overall declines in cancer mortality in the USA over the past three decades, many patients in community settings fail to receive evidence-based cancer care. Networks that link academic medical centers (AMCs) and community providers may reduce disparities by creating access to specialized expertise and care, but research on network effectiveness is mixed. The objective of this study was to identify factors related to whether and how an exemplar AMC network served to provide advice and referral access in community settings. Methods An embedded in–depth single case study design was employed to study a network in the Midwest USA that connects a leading cancer specialty AMC with community practices. The embedded case units were a subset of 20 patients with young-onset colorectal cancer or risk-related conditions and the providers involved in their care. The electronic health record (EHR) was reviewed from January 1, 1990, to February 28, 2018. Social network analysis identified care, advice, and referral relationships. Within-case process tracing provided detailed accounts of whether and how the network provided access to expert, evidence-based care or advice in order to identify factors related to network effectiveness. Results The network created access to evidence-based advice or care in some but not all case units, and there was variability in whether and how community providers engaged the network, including the path for referrals to the AMC and the way in which advice about an evidence-based approach to care was communicated from AMC specialists to community providers. Factors related to instances when the network functioned as intended included opportunities for both rich and lean communication between community providers and specialists, coordinated referrals, and efficient and adequately utilized documentation systems. Conclusions Network existence alone is insufficient to open up access to evidence-based expertise or care for patients in community settings. In-depth understanding of how this network operated provides insight into factors that support or inhibit the potential of networks to minimize disparities in access to evidence-based community cancer care, including both personal and organizational factors.

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“…1 Oncological networks often contain a structured care pathway and multidisciplinary tumor boards aiming to reduce practice variation, provide educational opportunities for all specialists involved, and reduce individual physician biases. 2,3 Interhospital collaboration also contributes to improved access to evidence-based health care, [4][5][6] new treatment options, and clinical studies. 7,8 Previously, we have demonstrated the impact of a regional network on referral patterns in patients with thyroid cancer.…”

mentioning

confidence: 99%

Regional Collaboration and Trends in Clinical Management of Thyroid Cancer

van Dijk,

Coerts,

Lončar

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveThis study examines the trends in the management of thyroid cancer and clinical outcomes in the Southwestern region of The Netherlands from 2010 to 2021, where a regional collaborative network has been implemented in January 2016.Study DesignRetrospective cohort study.SettingThis study encompasses all patients diagnosed with thyroid cancer of any subtype between January 2010 and June 2021 in 10 collaborating hospitals in the Southwestern region of The Netherlands.MethodsThe primary outcome of this study was the occurrence of postoperative complications. Secondary outcomes were trends in surgical management, centralization, and waiting times of patients with thyroid cancer.ResultsThis study included 1186 patients with thyroid cancer. Median follow‐up was 58 [interquartile range: 24‐95] months. Surgery was performed in 1027 (86.6%) patients. No differences in postoperative complications, such as long‐term hypoparathyroidism, permanent recurrent nerve paresis, or reoperation due to bleeding were seen over time. The percentage of patients with low‐risk papillary thyroid carcinoma referred to the academic hospital decreased from 85% (n = 120/142) in 2010 to 2013 to 70% (n = 120/171) in 2014 to 2017 and 62% (n = 100/162) in 2018 to 2021 (P < .01). The percentage of patients undergoing a hemithyroidectomy alone was 9% (n = 28/323) in 2010 to 2013 and increased to 20% (n = 63/317; P < .01) in 2018 to 2021.ConclusionThe establishment of a regional oncological network coincided with a de‐escalation of thyroid cancer treatment and centralization of complex patients and interventions. However, no differences in postoperative complications over time were observed. Determining the impact of regional oncological networks on quality of care is challenging in the absence of uniform quality indicators.

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Provider-Based Research Networks Demonstrate Greater Hospice Use for Minority Patients With Lung Cancer

Abstract: Minority patients with lung cancer receiving treatment in cancer-focused PBRN- affiliated practices have greater hospice enrollment than those treated in academic and community practices.

Cited by 7 publications

References 37 publications

Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture

Comparison of practice based research network based quality improvement technical assistance and evaluation to other ongoing quality improvement efforts for changes in agency culture

Tracing the potential of networks to improve community cancer care: an in-depth single case study

Regional Collaboration and Trends in Clinical Management of Thyroid Cancer

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