What is the role of middle managers in innovation implementation in the cancer system?

Over the past few decades, there have been many important research discoveries related to cancer diagnosis and treatment. However, these discoveries will not benefit patients unless they are adopted and used by clinicians and hospitals within the health system. Many studies in Canada and Nova Scotia have shown that research evidence is not consistently used in practice. These studies have examined various areas of cancer care (for example, surgery, treatment, and follow-up care) and various cancer sites (for example, breast, colorectal, and lung cancers). A growing body of research suggests that the movement of new knowledge, tools, and practices into healthcare settings are complex processes. Our recent work found that the support of middle managers (that is, employees who are supervised by a hospital's top managers and who supervise frontline employees) was a key factor that influenced the implementation of a new tool in Nova Scotia's cancer system. However, little is known with respect to the role that middle managers play in the implementation of new knowledge in healthcare settings. The goals of this study are to explore the role of middle managers in the adoption and implementation of new knowledge in cancer care and to identify ways to increase middle managers' support for these undertakings. We will talk to middle managers in Nova Scotia's and New Brunswick's cancer systems, and in associated departments, and ask them to reflect on their experiences with moving new knowledge into the cancer system. This study will build on our previous work and help address an important gap in the research literature on the role and influence of middle managers. The information we gain will also help us identify and develop practical ways to support the implementation of new knowledge in both province's cancer systems. This is important since we know that large gains could be made in reducing the cancer burden if we routinely used research evidence in everyday practice.