Synoptic surgical reporting for breast cancer surgery: an innovation in knowledge translation

Temple, Walley J.; Francis, Wesley; Tamano, Evangeline; Dabbs, Kelly; Mack, Lloyd A.; Fields, Anthony

doi:10.1016/j.amjsurg.2009.07.037

Cited by 29 publications

(19 citation statements)

References 15 publications

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“…Research has consistently demonstrated that synoptic reports greatly improve the quality of pathology [1,2,8-19] and surgical [5,20-24] reporting. When electronic, synoptic reporting tools (SRTs) result in health system efficiencies [24-26] and provide an effective mechanism to generate real-time data [20,25,27,28]. They have been widely endorsed as a means of standardizing cancer reporting, and improving the availability and quality of clinical information for persons diagnosed with cancer [29-33].…”

Section: Introductionmentioning

confidence: 99%

Multi-level factors influence the implementation and use of complex innovations in cancer care: a multiple case study of synoptic reporting

et al. 2014

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BackgroundThe implementation of innovations (i.e., new tools and practices) in healthcare organizations remains a significant challenge. The objective of this study was to examine the key interpersonal, organizational, and system level factors that influenced the implementation and use of synoptic reporting tools in three specific areas of cancer care.MethodsUsing case study methodology, we studied three cases in Nova Scotia, Canada, wherein synoptic reporting tools were implemented within clinical departments/programs. Synoptic reporting tools capture and present information about a medical or surgical procedure in a structured, checklist-like format and typically report only items critical for understanding the disease and subsequent impacts on patient care. Data were collected through semi-structured interviews with key informants, document analysis, nonparticipant observation, and tool use/examination. Analysis involved production of case histories, in-depth analysis of each case, and a cross-case analysis. Numerous techniques were used during the research design, data collection, and data analysis stages to increase the rigour of this study.ResultsThe analysis revealed five common factors that were particularly influential to implementation and use of synoptic reporting tools across the three cases: stakeholder involvement, managing the change process (e.g., building demand, communication, training and support), champions and respected colleagues, administrative and managerial support, and innovation attributes (e.g., complexity, compatibility with interests and values). The direction of influence (facilitating or impeding) of each of these factors differed across and within cases.ConclusionsThe findings demonstrate the importance of a multi-level contextual analysis to gaining both breadth and depth to our understanding of innovation implementation and use in health care. They also provide new insights into several important issues under-reported in the literature on moving innovations into healthcare practice, including the role of middle managers in implementation efforts and the importance of attending to the interpersonal aspects of implementation.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-014-0121-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Multi-level factors influence the implementation and use of complex innovations in cancer care: a multiple case study of synoptic reporting

et al. 2014

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“…• Contact for ongoing technical support for colorectal, 37 breast, 38 thyroid, 39 and pancreatic cancers, 40 as well as nonmalignant operative procedures. 41,42 Given this evidence, a growing number of international jurisdictions are moving to this method of reporting.…”

Section: Selecting Potentially Useful Framework To Advance Our Undermentioning

confidence: 99%

Exploring the Usefulness of Two Conceptual Frameworks for Understanding How Organizational Factors Influence Innovation Implementation in Cancer Care

Urquhart¹,

Sargeant²,

Grunfeld³

2013

Journal of Continuing Education in the Health Professions

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Moving knowledge into practice and the implementation of innovations in health care remain significant challenges. Few researchers adequately address the influence of organizations on the implementation of innovations in health care. The aims of this article are to (1) present 2 conceptual frameworks for understanding the organizational factors important to the successful implementation of innovations in health care settings; (2) discuss each in relation to the literature; and (3) briefly demonstrate how each may be applied to 3 initiatives involving the implementation of a specific innovation-synoptic reporting tools-in cancer care. Synoptic reporting tools capture information from diagnostic tests, surgeries, and pathology examinations in a standardized, structured manner and contain only the information necessary for patient care. The frameworks selected were the Promoting Action on Research Implementation in Health Services framework and an organizational framework of innovation implementation; these frameworks arise from different disciplines (nursing and management, respectively). The constructs from each framework are examined in relation to the literature, with each construct applied to synoptic reporting tool implementation to demonstrate how each may be used to inform both practice and research in this area. By improving our understanding of existing frameworks, we enhance our ability to more effectively study and target implementation processes.

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“…Since that time, researchers have consistently demonstrated that synoptic reports (even paper-based 'checklist' formats) vastly improve the quality of pathology reporting in colorectal [1,2,9-13], breast [1,9,14-16], lung [1,17], prostate [1], pancreatic [18], melanoma [19], and hematolymphoid cancers [20]. More recently, synoptic reporting has been shown to improve the quality of surgical reporting for a variety of malignancies, including colorectal [7], breast [21], thyroid [22], and pancreatic cancers [23], as well as non-malignant operative procedures [24,25]. …”

Section: Introductionmentioning

confidence: 99%

“…Beyond improving completeness of reporting and availability/immediacy of reports, synoptic reporting tools have the potential to improve quality of care by integrating practice guidelines/best evidence into report templates [21,26] and providing an efficient, real-time mechanism to generate data from the diagnostic and peri-operative periods [21,26,28,29]. These data may be used to provide real-time performance feedback to physicians and surgeons as well as enable improved process and outcomes measurement.…”

Section: Introductionmentioning

confidence: 99%

Exploring the interpersonal-, organization-, and system-level factors that influence the implementation and use of an innovation-synoptic reporting-in cancer care

et al. 2012

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BackgroundThe dominant method of reporting findings from diagnostic and surgical procedures is the narrative report. In cancer care, this report inconsistently provides the information required to understand the cancer and make informed patient care decisions. Another method of reporting, the synoptic report, captures specific data items in a structured manner and contains only items critical for patient care. Research demonstrates that synoptic reports vastly improve the quality of reporting. However, synoptic reporting represents a complex innovation in cancer care, with implementation and use requiring fundamental shifts in physician behaviour and practice, and support from the organization and larger system. The objective of this study is to examine the key interpersonal, organizational, and system-level factors that influence the implementation and use of synoptic reporting in cancer care.MethodsThis study involves three initiatives in Nova Scotia, Canada, that have implemented synoptic reporting within their departments/programs. Case study methodology will be used to study these initiatives (the cases) in-depth, explore which factors were barriers or facilitators of implementation and use, examine relationships amongst factors, and uncover which factors appear to be similar and distinct across cases. The cases were selected as they converge and differ with respect to factors that are likely to influence the implementation and use of an innovation in practice. Data will be collected through in-depth interviews, document analysis, observation of training sessions, and examination/use of the synoptic reporting tools. An audit will be performed to determine/quantify use. Analysis will involve production of a case record/history for each case, in-depth analysis of each case, and cross-case analysis, where findings will be compared and contrasted across cases to develop theoretically informed, generalisable knowledge that can be applied to other settings/contexts. Ethical approval was granted for this study.DiscussionThis study will contribute to our knowledge base on the multi-level factors, and the relationships amongst factors in specific contexts, that influence implementation and use of innovations such as synoptic reporting in healthcare. Such knowledge is critical to improving our understanding of implementation processes in clinical settings, and to helping researchers, clinicians, and managers/administrators develop and implement ways to more effectively integrate innovations into routine clinical care.

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Synoptic surgical reporting for breast cancer surgery: an innovation in knowledge translation

Cited by 29 publications

References 15 publications

Multi-level factors influence the implementation and use of complex innovations in cancer care: a multiple case study of synoptic reporting

Multi-level factors influence the implementation and use of complex innovations in cancer care: a multiple case study of synoptic reporting

Exploring the Usefulness of Two Conceptual Frameworks for Understanding How Organizational Factors Influence Innovation Implementation in Cancer Care

Exploring the interpersonal-, organization-, and system-level factors that influence the implementation and use of an innovation-synoptic reporting-in cancer care

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