CoP in cancer surgery Knowledge Transfer

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CoP in cancer surgery Knowledge Transfer
Exchange Community of Practice April 1st meeting
Michael Fung Kee Fung, MB, BS, FRCS Lead,
Knowledge Translation, Surgical Oncology
Program, Cancer Care Ontario
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s
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• Improvement Process
• Re-design
• Realignment

• Qualitative
• Teams
• Trust
• Leadership
• Professional Development

• Quantitative
• Guidelines
• Data Elements
• Evidence-based
• Products/Projects

CoP
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CoP Deliverables

• Disease site specific priorities, expressing the
  vision of practicing physicians aligned with
  hospital operating plans
• A single set of common regional guidelines and
  pathways, most of which can be implemented
  without major capital expenditures, improving
  quality of care and culture
• A core group of clinical leadership and
  facilitators, knowledgeable in all major aspects
  of the hospitals business, who become a major
  source of informal inter-organizational and
  inter-professional collaboration for the benefit
  of all patients in the Champlain region.
• An improved work climate, which strengthens
  culture of collaboration and facilitates
  recruitment and retention

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• Clinicians who responded to the survey
• Reported change in practice according to regional
  standards (56)
• Indicated more interest in participation in MCC
  and other regional professional development
  opportunities (five times more respondents in
  2007 would like to participate in MCC compared to
  the previous year results)
• Believe that the key CoP functions are to
  facilitate regional linkages and the culture of
  collaboration (89), innovation support (85),
  knowledge sharing (84)

Survey Results Barriers for participation

• Who responded?
• 55 response rate
• 60/40 split in community vs. academic affiliation
• Shift toward more multidisciplinary
  representation compared to 2006 survey

surgeon 24
surgical oncologist 6
medical oncologist 3
radiation oncologist 3
radiologist 2
pathologist 2
nurse 12
administrator 8
gastroenterologist 5
total 65
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Progress to date
Targets 2005 2006 2007
Lapcolon guideline uptake (MIS vs. open approach) 25 35
Develop regional clinical inpatient and outpatient pathways with common assessment and diagnostic criteria 0 18 pts at TOH
Number of surgical cases submitted for MCC 11 27 34
Develop regional standard for the Sentinel node biopsy as an option for axillary staging 0 12pts Winchester 35 pts Cornwall
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Integrated CoP Knowledge Spiral Model
LongTerm Objective
Quality of care
Strategic Foundation Knowledge Management
CoP tools
Project Management
Communication
CME/CPD
Access to evidence
Access to data

• CoPs are groups of people who share a concern, a
  set of problems, or a passion about a topic
• and who deepen their knowledge and expertise in
  this area by interacting on an ongoing basis

Evidence gaps/ quantitative
Practice gaps/ qualitative
Process gaps/ improvement science
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Reference

• Fung Kee Fung, M. et al, Development of
  communities of Practice to facilitate quality
  improvements in surgical oncology. Quality
  Management Health Care, 2008, 172, pp 174-185.