title: A Qualitative Evaluation of Web-Based Cancer Care Quality Improvement Toolkit Use in the Veterans Health Administration.
abstract: BACKGROUND
  Disease severity, complexity, and patient burden highlight cancer care as a target for quality improvement (QI) interventions. The Veterans Health Administration (VHA) implemented a series of disease-specific online cancer care QI toolkits.
  
  
  OBJECTIVE
  To describe characteristics of the toolkits, target users, and VHA cancer care facilities that influenced toolkit access and use and assess whether such resources were beneficial for users.
  
  
  METHODS
  Deductive content analysis of detailed notes from 94 telephone interviews with individuals from 48 VHA facilities. We evaluated toolkit access and use across cancer types, participation in learning collaboratives, and affiliation with VHA cancer care facilities.
  
  
  RESULTS
  The presence of champions was identified as a strong facilitator of toolkit use, and learning collaboratives were important for spreading information about toolkit availability. Identified barriers included lack of personnel and financial resources and complicated approval processes to support tool use.
  
  
  CONCLUSIONS
  Online cancer care toolkits are well received across cancer specialties and provider types. Clinicians, administrators, and QI staff may benefit from the availability of toolkits as they become more reliant on rapid access to strategies that support comprehensive delivery of evidence-based care. Toolkits should be considered as a complement to other QI approaches.
authors.affiliation: Center for the Study of Healthcare Provider Behavior, VA Greater Los Angeles Healthcare System, Los Angeles, California (Drs. Bowman, Luck, York and Ms. Smith); College of Public Health and Human Sciences, Oregon State University, Corvallis (Dr Luck); Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California (Drs Gale and Asch); and Division of General Medical Disciplines, Stanford University, Palo Alto, California (Dr Asch).
authors.forename: Candice
authors.initials: C
authors.lastname: Bowman
authors.forename: Jeff
authors.initials: J
authors.lastname: Luck
authors.forename: Randall C
authors.initials: RC
authors.lastname: Gale
authors.forename: Nina
authors.initials: N
authors.lastname: Smith
authors.forename: Laura S
authors.initials: LS
authors.lastname: York
authors.forename: Steven
authors.initials: S
authors.lastname: Asch
mesh_terms: D003695:Delivery of Health Care / Q000592:standards*; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D009369:Neoplasms / Q000628:therapy; D015397:Program Evaluation; D036301:Qualitative Research; D058996:Quality Improvement / Q000458:organization & administration*; D014481:United States; D014493:United States Department of Veterans Affairs