Exploring a “community of practice” methodology as a regional platform for large-scale collaboration in cancer surgery—the Ottawa approach

Abstract

not on the role of cops in large-scale collaborations across multiple disciplines 6,7 .The idea that a cop can be deliberately started and supported by an organization to facilitate multiprofessional collaboration is a new and emerging area of enquiry. It has also been increasingly used as a theoretical approach to analyze and compare large-scale health care collaborations 1,5,8 . Additionally, a number of recent research findings have suggested that features of cop might be beneficial in addressing the challenges of multi-professional, multi-organizational collaborations [9][10][11] .The present paper attempts to close the gap between cop conceptualization and its application in health care settings by describing a working model that was used in the implementation of regional cops in cancer surgery. In addition, we explore the nature of peer networks within health care organizations and the opportunity for integrating existing networks from independent hospitals within a region into a manageable community. RESEARCH DESIGN Phase One: Literature ReviewIn our 2007 study of collaborative initiatives development in health care, we explored the possibility of applying a cop model to facilitate quality improvements in cancer surgery 8 . Using that model as an analytic approach in our 2009 systematic literature review of surgical collaborations, we looked for common elements in enabling operating infrastructures and tools 2 . The review further enhanced development of our model. The optimal structure for the collaboration was described as regional in scope, evidence-based, data-driven, and supported institutionally through strategic partnerships providing comprehensive support as part of the continuous quality improvement cycle 2,12 .Here, we examine recent findings on the role of cops in large-scale health care collaborations, with a ABSTRACTPressing challenges have forced health care providers to rethink traditional silos and professional boundaries. Communities of practice (cops) have been identified as a means to share knowledge across silos and boundaries. However, clarity sufficient to enable their easy and uniform reproducibility is lacking, leading to a gap between cop conceptualization and implementation. This paper explores a cop structure and outlines a framework that is adaptable, measurable, and implementable across health disciplines in a regional cancer surgery program. KEY WORDSCommunity of practice, regional collaborations, quality improvement, health care services research, knowledge translation

Communities of practice in healthcare: A framework for managing knowledge sharing in operations

“…In some cases, preexisting and “slumbering” CoPs can be leveraged when intentionally developing CoPs by “manipulating emergence” of new CoPs (Kislov, Walshe, & Harvey, ) and relying on the preexisting network and social capital (Fung‐Kee‐Fung et al, ; Iaquinto, Ison, & Faggian, ). By making CoP participation voluntary, the employees are allowed to decide whether the CoP is relevant for their jobs (Fung‐Kee‐Fung, Boushey, & Morash, ; Hemmasi & Csanda, ; Scarso et al, ) and to choose if the CoP focus is of practical interest to them (Akkerman et al, ; Wolf, Späth, & Haefliger, ). In this way, the CoP should include only genuinely involved and interested employees, which favours its successful development (Wenger, ).…”

“…CoP is a social phenomenon, hence physical interaction between CoP members is regarded as important for its success (Fung‐Kee‐Fung, Boushey, Watters, et al, ; Iaquinto et al, ; Orr, ; Wenger et al, ), whereas reduced face‐to‐face interaction is found to have negative effects on CoP performance (Schenkel & Teigland, ). A meeting between CoP participants must provide a risk‐free zone, which caters for participants' ability to ask questions without risk of sanction (Borzillo, ), enable in‐depth and undisturbed discussions (Orr, ), and facilitate a collaborative work effort (Fung‐Kee‐Fung, Boushey, & Morash, ). A designated meeting room for the CoP can fulfil this function.…”

Regional Process Redesign of Lung Cancer Care: A Learning Health System Pilot Project

“…A cop, in this context, is a collective of multiple stakeholders outside of the hierarchy of their institution, considered equal, and sharing a common goal of learning and sharing in order to improve something, in this case, lung cancer care. Application is described in detail in our previous publications [21][22][23][24][25] . This has provided the regional foundation for the awareness and trusted relationships necessary to create positive perceptions of change, commitment, and ownership of large scale improvements.…”

Quality measurement in breast cancer

“…Interestingly, the most successful quality improvement programs are those that engage physicians in development and implementation. One such effort is the Community of Practice effort in surgical oncology in Ontario Canada . This effort demonstrates the effectiveness of grass‐roots involvements of practicing surgeon in substantive quality improvement.…”