Aim: The Sydney Catalyst Translational Cancer Research Centre of Central Sydney and Regional NSW is a multi-site and multi-disciplinary centre incorporating clinical cancer services and research organisations. The T2-3 research stream focuses on implementing evidence into practice. Our Flagship program has been developed to address the significant gaps in lung cancer care. The aim of this presentation is to detail the systematic approach we have taken in developing this program.
Method: Research activities have included: selecting a theoretical foundation from the implementation science literature; developing methodologies for, and conducting: an evidence-practice gap analysis (a five step process that includes evidence review and local data analysis); priority setting focus groups conducted with three lung cancer services; and a process mapping exercise with each service. We drew on evidence-based theories or approaches for each activity and adapted these for the program of work.
Results: We identified and pilot-tested seven evidence-practice gaps in lung cancer care. Results from the prioritisation process (3 focus groups, 42 participants in total) highlighted two priority gaps to target for implementation: reducing the time from first presentation of symptoms to diagnosis and referral for care, and improving early referral to palliative care services. Process mapping resulted in detailed maps of the patient journey from entry points into cancer services via primary care and emergency department admissions, routes to diagnosis and referral for treatment, through to survivorship or palliative care. The maps highlight the delays and complexities for patients navigating health services, particularly for those living in regional and rural areas.
Conclusions: This collaborative program between clinicians and researchers has targeted where improvements can be made in lung cancer care. We are now preparing to implement local care pathways in an effort to reduce the gaps in lung cancer care.