Resumen
Objectives Moving innovations into healthcare organisations to increase positive health outcomes remains a significant challenge. Even when knowledge and tools are adopted, they often fail to become integrated into the long-term routines of organisations. The objective of this study was to identify factors and processes influencing the sustainability of innovations in cancer survivorship care. Design Qualitative study using semistructured, in-depth interviews, informed by grounded theory. Data were collected and analysed concurrently using constant comparative analysis. Setting 25 cancer survivorship innovations based in six Canadian provinces. Participants Twenty-seven implementation leaders and relevant staff from across Canada involved in the implementation of innovations in cancer survivorship. Results The findings were categorised according to determinants, processes and implementation outcomes, and whether a factor was necessary to sustainability, or important but not necessary. Seven determinants, six processes and three implementation outcomes were perceived to influence sustainability. The necessary determinants were (1) management support; (2) organisational and system-level priorities; and (3) key people and expertise. Necessary processes were (4) innovation adaptation; (5) stakeholder engagement; and (6) ongoing education and training. The only necessary implementation outcome was (7) widespread staff and organisational buy-in for the innovation. Conclusions Factors influencing the sustainability of cancer survivorship innovations exist across multiple levels of the health system and are often interdependent. Study findings may be used by implementation teams to plan for sustainability from the beginning of innovation adoption initiatives.
| Idioma original | English |
|---|---|
| Número de artículo | 042503 |
| Publicación | BMJ Open |
| Volumen | 11 |
| N.º | 2 |
| DOI | |
| Estado | Published - feb. 5 2021 |
Nota bibliográfica
Funding Information:Funding The work was supported by a research grant from the Canadian Cancer
Funding Information:
the sustained use of any innovation. Their experience was that even with all other pieces in place, it is extremely challenging to sustain any innovation without management support. As one participated stated, ‘Management support, for sure, is very important, especially for growth. Um, very, very important’ (Participant 19). Participants noted that management support tends to result in ongoing funding, whether this is the direct provision of funds (eg, out of their programme budget) or advocating for funding from other sources. Participants also described how it is often difficult for managers to support innovations in survivorship care because of competing priorities and that survivorship care does not result in quantifiable metrics in the same way other areas of care do: I would say that it’s one of the … tougher components for people, for senior management, to buy into because it’s a softer metric to try to collect in a way. Because it’s not like you’ve got numbers of patients going through chemo or radiation. It’s not, you know, survivorship care is a lot harder to look at that data and try to figure out if it’s meaningful or worth it. (Participant 2) Participants also noted that management support is much higher when an innovation and its sustainment are appropriately resourced and funded. Innovations that do not have secure funding require managers to transfer operational funds and/or allocate other resources (eg, staff time) away from existing programmes and services.
Publisher Copyright:
©
ASJC Scopus Subject Areas
- General Medicine
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't
ODS de las Naciones Unidas
Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible
