Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | São Paulo medical journal (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000500438 |
Resumo: | ABSTRACT BACKGROUND: Management of rectal cancer has become more complex with multimodality therapy (neoadjuvant chemoradiotherapy and surgery) and this has led to the need to organize multidisciplinary teams. The aim of this study was to report on the planning, implementation and evaluation of an integrated care pathway for neoadjuvant treatment of middle and lower rectal cancer. DESIGN AND SETTING: This was a cross-sectional post-implementation study that was carried out at a public university cancer center. METHODS: The Framework for Program Evaluation in Public Health of the Centers for Disease Control and Prevention (CDC) was used to identify resources and activities; link results from activities and outcomes with expected goals; and originate indicators and outcome measurements. RESULTS: The logic model identified four activities: stakeholders’ engagement, clinical pathway development, information technology improvements and training programs; and three categories of outcomes: access to care, effectiveness and organizational outcomes. The measurements involved 218 patients, among whom 66.3% had their first consultation within 15 days after admission; 75.2% underwent surgery < 14 weeks after the end of neoadjuvant treatment and 72.7% completed the treatment in < 189 days. There was 100% adherence to the protocol for the regimen of 5-fluorouracil and leucovorin. CONCLUSIONS: The logic model was useful for evaluating the implementation of the integrated care pathways and for identifying measurements to be made in future outcome studies. |
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Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model frameworkRectal neoplasmsInterdisciplinary studiesDisease managementImplementation scienceDecision makingQualitative researchLine of careChronic non-communicable diseasesHealthcare workABSTRACT BACKGROUND: Management of rectal cancer has become more complex with multimodality therapy (neoadjuvant chemoradiotherapy and surgery) and this has led to the need to organize multidisciplinary teams. The aim of this study was to report on the planning, implementation and evaluation of an integrated care pathway for neoadjuvant treatment of middle and lower rectal cancer. DESIGN AND SETTING: This was a cross-sectional post-implementation study that was carried out at a public university cancer center. METHODS: The Framework for Program Evaluation in Public Health of the Centers for Disease Control and Prevention (CDC) was used to identify resources and activities; link results from activities and outcomes with expected goals; and originate indicators and outcome measurements. RESULTS: The logic model identified four activities: stakeholders’ engagement, clinical pathway development, information technology improvements and training programs; and three categories of outcomes: access to care, effectiveness and organizational outcomes. The measurements involved 218 patients, among whom 66.3% had their first consultation within 15 days after admission; 75.2% underwent surgery < 14 weeks after the end of neoadjuvant treatment and 72.7% completed the treatment in < 189 days. There was 100% adherence to the protocol for the regimen of 5-fluorouracil and leucovorin. CONCLUSIONS: The logic model was useful for evaluating the implementation of the integrated care pathways and for identifying measurements to be made in future outcome studies.Associação Paulista de Medicina - APM2019-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000500438Sao Paulo Medical Journal v.137 n.5 2019reponame:São Paulo medical journal (Online)instname:Associação Paulista de Medicinainstacron:APM10.1590/1516-3180.2018.0364160919info:eu-repo/semantics/openAccessKobayashi,Silvia TakanohashiCampolina,Alessandro GonçalvesDiz,Maria del Pilar EstevezSoárez,Patrícia Coelho deeng2020-01-08T00:00:00Zoai:scielo:S1516-31802019000500438Revistahttp://www.scielo.br/spmjhttps://old.scielo.br/oai/scielo-oai.phprevistas@apm.org.br1806-94601516-3180opendoar:2020-01-08T00:00São Paulo medical journal (Online) - Associação Paulista de Medicinafalse |
dc.title.none.fl_str_mv |
Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework |
title |
Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework |
spellingShingle |
Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework Kobayashi,Silvia Takanohashi Rectal neoplasms Interdisciplinary studies Disease management Implementation science Decision making Qualitative research Line of care Chronic non-communicable diseases Healthcare work |
title_short |
Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework |
title_full |
Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework |
title_fullStr |
Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework |
title_full_unstemmed |
Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework |
title_sort |
Integrated care pathway for rectal cancer treatment: cross-sectional post-implementation study using a logic model framework |
author |
Kobayashi,Silvia Takanohashi |
author_facet |
Kobayashi,Silvia Takanohashi Campolina,Alessandro Gonçalves Diz,Maria del Pilar Estevez Soárez,Patrícia Coelho de |
author_role |
author |
author2 |
Campolina,Alessandro Gonçalves Diz,Maria del Pilar Estevez Soárez,Patrícia Coelho de |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Kobayashi,Silvia Takanohashi Campolina,Alessandro Gonçalves Diz,Maria del Pilar Estevez Soárez,Patrícia Coelho de |
dc.subject.por.fl_str_mv |
Rectal neoplasms Interdisciplinary studies Disease management Implementation science Decision making Qualitative research Line of care Chronic non-communicable diseases Healthcare work |
topic |
Rectal neoplasms Interdisciplinary studies Disease management Implementation science Decision making Qualitative research Line of care Chronic non-communicable diseases Healthcare work |
description |
ABSTRACT BACKGROUND: Management of rectal cancer has become more complex with multimodality therapy (neoadjuvant chemoradiotherapy and surgery) and this has led to the need to organize multidisciplinary teams. The aim of this study was to report on the planning, implementation and evaluation of an integrated care pathway for neoadjuvant treatment of middle and lower rectal cancer. DESIGN AND SETTING: This was a cross-sectional post-implementation study that was carried out at a public university cancer center. METHODS: The Framework for Program Evaluation in Public Health of the Centers for Disease Control and Prevention (CDC) was used to identify resources and activities; link results from activities and outcomes with expected goals; and originate indicators and outcome measurements. RESULTS: The logic model identified four activities: stakeholders’ engagement, clinical pathway development, information technology improvements and training programs; and three categories of outcomes: access to care, effectiveness and organizational outcomes. The measurements involved 218 patients, among whom 66.3% had their first consultation within 15 days after admission; 75.2% underwent surgery < 14 weeks after the end of neoadjuvant treatment and 72.7% completed the treatment in < 189 days. There was 100% adherence to the protocol for the regimen of 5-fluorouracil and leucovorin. CONCLUSIONS: The logic model was useful for evaluating the implementation of the integrated care pathways and for identifying measurements to be made in future outcome studies. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000500438 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-31802019000500438 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-3180.2018.0364160919 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
publisher.none.fl_str_mv |
Associação Paulista de Medicina - APM |
dc.source.none.fl_str_mv |
Sao Paulo Medical Journal v.137 n.5 2019 reponame:São Paulo medical journal (Online) instname:Associação Paulista de Medicina instacron:APM |
instname_str |
Associação Paulista de Medicina |
instacron_str |
APM |
institution |
APM |
reponame_str |
São Paulo medical journal (Online) |
collection |
São Paulo medical journal (Online) |
repository.name.fl_str_mv |
São Paulo medical journal (Online) - Associação Paulista de Medicina |
repository.mail.fl_str_mv |
revistas@apm.org.br |
_version_ |
1754209266714017792 |