title: Quality improvement: an assessment of participation and attitudes of medical oncologists.
abstract: OBJECTIVE
  Although quality improvement (QI) is an integral part of cancer care, there are few QI publications in the medical oncology literature. We examined the prevailing attitudes of medical oncologists toward QI and causes for the low QI publication rate in the medical oncology literature.
  
  
  METHODS
  Using a modified Dillman method, we distributed a 13-question online survey to medical oncologists across Canada asking about their attitudes toward and involvement in QI and perceived barriers to publishing QI studies.
  
  
  RESULTS
  We attained a 43% response rate (143 of 332). Of the responding oncologists, 97% (138) agreed that QI was an important aspect of their practice, although only 49% (70) had participated in QI in the past 5 years. Physicians with administrative responsibility were more likely than clinicians to be involved in QI (P = .008). Most QI participants focused on domains of safety (70%) and patient centeredness (67%). Among QI participants, 72% did not publish their findings, because of lack of time (34%), no identifiable journals (14%), and unfamiliarity with QI methodology (10%). Barriers for QI nonparticipants included uncertainty about how to get involved (45%), lack of time (18%), and limited institutional support or recognition (18%). QI participants had greater awareness of recent practice-changing QI publications compared with nonparticipants (P = .003).
  
  
  CONCLUSIONS
  Canadian medical oncologists face limitations to participating in and publishing QI initiatives because of lack of knowledge about ongoing initiatives, lack of time, and lack of resources to aid publication. Improving networking opportunities and prioritizing QI at the institutional level can address this need.
authors.affiliation: Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, Ontario, Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Lim
authors.affiliation: Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, Ontario, Canada.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Cheung
authors.affiliation: Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, Ontario, Canada.
authors.forename: Bryan
authors.initials: B
authors.lastname: Franco
authors.affiliation: Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, Ontario, Canada.
authors.forename: Laavanya
authors.initials: L
authors.lastname: Dharmakulaseelan
authors.affiliation: Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, Ontario, Canada.
authors.forename: Evan
authors.initials: E
authors.lastname: Chong
authors.affiliation: Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, Ontario, Canada.
authors.forename: Amesha
authors.initials: A
authors.lastname: Iyngarathasan
authors.affiliation: Sunnybrook Health Sciences Center, Odette Cancer Center, Toronto, Ontario, Canada simron.singh@sunnybrook.ca.
authors.forename: Simron
authors.initials: S
authors.lastname: Singh
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D003266:Continuity of Patient Care / Q000592:standards; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D009369:Neoplasms / Q000628:therapy*; D061214:Patient Safety / Q000592:standards; D010818:Practice Patterns, Physicians'; D058996:Quality Improvement