title: Embedding continuous quality improvement processes in multidisciplinary teams in cancer care: exploring the boundaries between quality and implementation science.
abstract: Objective The aim of the present study was to identify key enabling factors for engaging multidisciplinary teams (MDTs) in cancer care across the spectrum of translational research and quality improvement (QI) projects. Methods The study was conducted in two large Sydney metropolitan hospitals. Qualitative methods, including structured observations of MDT meetings and semi-structured interviews with MDT leaders and champions, were used to identify how teams interact with and generate research and implementation initiatives. Enabling factors for and barriers to the engagement of MDTs in translational research and QI were identified. Results Four key enabling factors emerged from the analysis of data generated from observing 43 MDT meetings and 18 semi-structured interviews: (1) access to high-quality data around individual and team performance; (2) research-active team leaders; (3) having experts, such as implementation scientists, embedded into teams; and (4) having dedicated research or QI-focused meetings. Barriers included a lack of time, administrative support, research expertise and access to real-time data. Conclusions The identification of enabling factors for and barriers to translational research and QI provides evidence for how multidisciplinary cancer care teams may best be engaged in research and QI that aims to improve service and care outcomes. What is known about the topic? MDTs are key to the delivery of cancer care in Australia, but there is scant research into how teams can best be engaged in translating research from basic science through to implementation science and QI. What does this paper add? This paper provides new evidence from an immersive study of cancer care MDTs in two large metropolitan hospitals in Sydney (NSW, Australia), regarding the key enabling factors for and barriers to successful engagement in translational research and QI in cancer care. What are the implications for practitioners? Cancer care professionals in MDTs are presented with an opportunity to embed translational research and QI into cancer care. MDTs can operate as an ideal vehicle to look beyond individual patient outcomes to broader trends and population health outcomes.
authors.affiliation: Discipline of Nursing and Midwifery, Faculty of Health, University of Canberra University Drive, Bruce, Canberra, ACT 2601, Australia.
authors.forename: Tracy E
authors.initials: TE
authors.lastname: Robinson
authors.affiliation: Research in Implementation Science and eHealth, Faculty of Health Sciences, University of Sydney, Sydney, NSW 2006, Australia. Email:.
authors.forename: Anna
authors.initials: A
authors.lastname: Janssen
authors.affiliation: Sydney West Translational Cancer Research Centre, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW 2145, Australia. Email: ;
authors.forename: Paul
authors.initials: P
authors.lastname: Harnett
authors.affiliation: Sydney West Translational Cancer Research Centre, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW 2145, Australia. Email: ;
authors.forename: Kylie E
authors.initials: KE
authors.lastname: Museth
authors.affiliation: Sydney West Translational Cancer Research Centre, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, NSW 2145, Australia. Email: ;
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Provan
authors.affiliation: School of Nursing and Midwifery, Monash University, Wellington Road, Clayton, Vic. 3800, Australia. Email.
authors.forename: Danny J
authors.initials: DJ
authors.lastname: Hills
authors.affiliation: Research in Implementation Science and eHealth, Faculty of Health Sciences, University of Sydney, Sydney, NSW 2006, Australia. Email:.
authors.forename: Tim
authors.initials: T
authors.lastname: Shaw
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D009517:New South Wales; D019370:Observation; D010348:Patient Care Team / Q000458:organization & administration*; D058996:Quality Improvement / Q000458:organization & administration*; D057170:Translational Research, Biomedical