Using a health system learning community strategy to address cancer disparities

Myers, Ronald E.; DiCarlo, Melissa; Romney, Martha; Fleisher, Linda; Sifri, Randa; Soleiman, Joy; Lambert, Emily; Rosenthal, Michael P.

doi:10.1002/lrh2.10067

Cited by 13 publications

(13 citation statements)

References 13 publications

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“…In terms of screening tests made available to study participants, each trial offered both SBT and colonoscopy as screening modalities. The Menon et al ( Myers et al, 2018 ) trial was the only study in which flexible sigmoidoscopy screening was also explicitly offered as a screening option.…”

Section: Resultsmentioning

confidence: 99%

“…In accordance with the integrated ISF and Collective Impact Model, the project team organized a coordinating team (CT), a steering committee (SC), and a patient and stakeholder advisory committee (PASAC) in each health system. This process is described in greater detail elsewhere ( Myers et al, 2018 ). The CT included experts in cancer prevention and control research and cancer screening in primary care.…”

Section: Methodsmentioning

confidence: 99%

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A learning community approach to identifying interventions in health systems to reduce colorectal cancer screening disparities

Man

DiCarlo

Lambert

et al. 2018

Preventive Medicine Reports

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Although colorectal cancer (CRC) screening in the United States has been increasing, screening rates are not optimal, and there are persistent disparities in CRC screening and mortality, particularly among minority patients. As most CRC screening takes place in primary care, health systems are well-positioned to address this important population health problem. However, most health systems have not actively engaged in identifying and implementing effective evidence-based intervention strategies that can raise CRC screening rates and reduce disparities. Drawing on the Collective Impact Model and the Interactive Systems Framework for Dissemination and Implementation, our project team applied a learning community strategy to help two health systems in southeastern Pennsylvania identify evidence-based CRC screening interventions for primary care patients. Initially, this approach involved activating a coordinating team, steering committee (health system leadership and stakeholder organizations), and patient and stakeholder advisory committee to identify candidate CRC screening intervention strategies. The coordinating team guided the steering committee through a scoping review to identify seven randomized trials that identified interventions that addressed CRC screening disparities. Subsequently, the coordinating team and steering committee applied a screening intervention classification typology to select an intervention strategy that involved using an outreach strategy to provide minority patients with access to both stool blood test and colonoscopy screening. Finally, the coordinating team and steering committee engaged the health system patient and stakeholder advisory committee in planning for intervention implementation, thus taking up the challenge of reducing and important health disparity in patient populations served by the two health systems.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A learning community approach to identifying interventions in health systems to reduce colorectal cancer screening disparities

Man

DiCarlo

Lambert

et al. 2018

Preventive Medicine Reports

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“…Patient and stakeholder committees have also been used to ensure successful maintenance of comprehensive LCS programs (Figure 2). These committees are comprised of key local stakeholders and organizations which can include representatives from participating healthcare systems, employer coalitions, health departments, major insurers, nonprofit and diversity organizations that may have a stake in disparities and cancer outcomes (75). In contrast to steering committees or multidisciplinary tumor boards that may meet every 1-2 weeks to determine timely plans for high-risks findings, patient and stakeholder committees meet approximately quarterly to review screening rates and related disparities to identify factors that may be affecting LCS and recommend strategies that improve efficacy of the local LCS program.…”

Section: Maintenance Phasementioning

confidence: 99%

Opportunities and challenges in lung cancer screening implementation: a narrative review

Núñez¹,

Steiling²,

Litle³

2021

Curr Chall Thorac Surg

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The U.S. Preventive Services Task Force and the Centers for Medicare and Medicaid Services (CMS) recommend lung cancer screening (LCS) for high risk current and former smokers. Developing a comprehensive LCS program requires coordinated planning from program conception through implementation and maintenance that address both pragmatic and regulatory matters. In this review article, we discuss the available evidence, guideline recommendations, and practical considerations for implementing a high-quality LCS program. Key factors in the initial planning phase include engagement of stakeholders with a particular focus on support from providers, patients and healthcare organizations. Additionally, it is important to consider the infrastructure and program design that will best serve local needs, and implement mandatory components such as a data registry and smoking cessation. We also discuss the implementation phase including strategies for optimizing the eligible patient population to be screened as well as the processes of shared decision making (SDM), standardization of screening results and communication of findings to patients. Once patients have been screened, maintenance of a successful LCS program requires iterative multidisciplinary reviews of key quality metrics and establishing systematic mechanisms to track evaluation, minimizing loss to follow-up. We also review other recommended components that contribute to maintaining a high-quality screening program such as a clinical screening coordinator, patient navigator, and tools to improve the uptake of and adherence to LCS.

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“…For example, health-care organizations often develop learning communities in which multidisciplinary professionals collaborate to address issues such as "dementia" (Sheaff et al, 2018), "cancer screening and disparities" (Myers et al, 2018) and "HIV" (Barbosu et al, 2017). It is worth noticing that from 2014-2016 the Agency for Health-care Research and Quality (AHRQ), i.e.…”

Section: Introductionmentioning

confidence: 99%

Effect of a community of practice on knowledge sharing across boundaries: the mediating role of learning goals

Matsuo

Aihara

2021

JKM

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Purpose A community of practice (CoP) is believed to be a driver for knowledge creation but it can hinder knowledge sharing across boundaries. Drawing on social cognitive theory, this study aims to investigate how a CoP within a single unit promotes knowledge sharing with other units by examining the mediating effect of the members’ learning goals (LG). Design/methodology/approach Structural equation modeling was conducted using a two-wave survey data on nurses from eight Japanese hospitals (n = 263). Findings The results indicated that LG fully and positively mediated the effect of a CoP on the knowledge-sharing intention of one unit toward other units and that LG fully and negatively mediated the effect of a CoP on knowledge withholding (KW) from other units. Practical implications Knowledge managers need to note that intellectual benefits from experienced CoP can play a key role in reducing the perceived risks associated with members’ knowledge sharing and in creating effective knowledge sharing with other units. Originality/value The main contribution is to identify the process by which CoP promotes knowledge sharing and prevents KW across boundaries mediated through LG. This study is the first to quantitatively show how LG cross inter-professional barriers caused by CoPs.

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Using a health system learning community strategy to address cancer disparities

Cited by 13 publications

References 13 publications

A learning community approach to identifying interventions in health systems to reduce colorectal cancer screening disparities

A learning community approach to identifying interventions in health systems to reduce colorectal cancer screening disparities

Opportunities and challenges in lung cancer screening implementation: a narrative review

Effect of a community of practice on knowledge sharing across boundaries: the mediating role of learning goals

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