Exploring experiences of implementing standardized cancer patient pathways within investigatory units \u2013 a qualitative study

Jeanette Winterling,Malin Gunarsson,Henna Hasson,Sara Delilovic,Jessica Dervish,Mårten Åhström

doi:10.1186/s12913-021-06915-1

Jeanette Winterling, Malin Gunarsson + Show 4 more

Open Access

https://doi.org/10.1186/s12913-021-06915-1

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Abstract

BackgroundIn the implementation of standardized cancer patient pathways (CPPs), the investigatory units, endoscopy, radiology and pathology, are crucial to ensure an eventual cancer diagnosis. However, when evaluating the implementation of CPPs, little attention has been paid to the healthcare professionals working in these units. The aim of this study was to explore experiences of the implementation of CPPs among health professionals in investigatory units.MethodsThis descriptive qualitative study included 55 health professionals working in investigatory units. Participants were interviewed in 2017–2018, and data were analysed using thematic analysis.ResultsThe health professionals reported benefits, facilitators and challenges when describing their experiences of implementing CPPs. Benefits included that CPP improved collaboration and increased focus on the patients. Facilitators in the implementation process included pre-existing well-functioning work processes and having supportive functions (e.g. coordinators). Challenges included the lack of staff and clinical equipment, as well as unjustified time-slots and incorrect referrals.ConclusionsThe findings show that most health professionals working in investigatory units’ experience benefits with the implementation of CPP, but the lack of resources was especially hard to overcome.

Highlights

In the implementation of standardized cancer patient pathways (CPPs), the investigatory units, endoscopy, radiology and pathology, are crucial to ensure an eventual cancer diagnosis
This means that the investigatory units, such as endoscopy and radiology, must have pre-booked time slots for investigations of cancer patients to ensure that cancer investigations, i.e. procedures or tests, needed to diagnose cancer, are performed within the given lead-time
Study setting This study explores experiences of implementing CPPs among healthcare professionals working in investigatory units: endoscopy, radiology and pathology in Region Stockholm

Summary

Introduction

In the implementation of standardized cancer patient pathways (CPPs), the investigatory units, endoscopy, radiology and pathology, are crucial to ensure an eventual cancer diagnosis. In contrast to Denmark, the Swedish model includes both primary and secondary care [4] and comprises three key concepts: first, manuals with recommended lead-times for each cancer pathway from first symptoms until start of treatment [4, 9]; Second, CPP-coordinators responsible for the administrative aspects of the CPP were located at the units involved in the pathways [10]; and the third key component concerned the introduction of so-called ‘unoccupied time slots’ within investigatory units This means that the investigatory units, such as endoscopy and radiology, must have pre-booked time slots for investigations of cancer patients to ensure that cancer investigations, i.e. procedures or tests, needed to diagnose cancer, are performed within the given lead-time. How well the investigatory units manage to implement the CPPs is a key factor in the success of the whole care chain

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