Best of Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Factors influencing organisational readiness for implementation of the Australian Clinical Pathway for the Screening, Assessment and Management of Anxiety and Depression in Adult Cancer Patients. (#235)

Liesbeth Geerligs 1 2 , Heather Shepherd 1 3 , Nicole Rankin 4 , Lindy Masya 1 , Jessica Cuddy 1 , Fiona White 1 , Joanne Shaw 1 3 , The ADAPT Program Group 1 , Phyllis Butow 1 3
  1. Psycho-oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia
  2. Sydney Catalyst Translational Cancer Research Centre, Sydney, NSW, Australia
  3. Centre for Psychological Medicine and Evidence-Based Decision Making (CeMPED), The University of Sydney, Sydney, NSW, Australia
  4. Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia

Aims: Translation of evidence-based psycho-oncology interventions into routine cancer care can significantly improve patient outcomes, yet successful implementation remains a challenge due to many real-world barriers. Organisational readiness for change is one such barrier garnering increasing attention. The current study sought to identify factors associated with readiness for implementing the Australian Clinical Pathway for the screening, assessment and management of anxiety and depression in adult cancer patients (ADAPT CP) within cancer services.

 

Methods: We collected data from multidisciplinary staff across six NSW cancer services who were preparing to implement the ADAPT CP.  Quantitative data (n=59) were collected using the validated Organisational Readiness for Implementing Change (ORIC) questionnaire (score range=12-60, with lower scores indicating greater readiness). We developed a semi-structured qualitative interview schedule based on the Promoting Action Research in Health Services (PARiHS) framework and carried out interviews with a purposive sample of staff across different roles (n=44).  Qualitative data were analysed thematically.

 

Results: Three services scored higher readiness to implement the pathway (ORIC mean range:15.13-19.75). The remaining services had mid-range readiness (mean range:25.61-33.25). Staff across all services reported positive beliefs about the need for a clinical pathway and ADAPT CP training, as well as concerns about the practicalities and workload of implementation. Staff at services with higher readiness described a more collaborative and proactive culture, strong communication processes, and greater flexibility regarding role responsibilities than services with mid-range readiness. Higher readiness services also reported greater engagement with the pathway and clear strategies for addressing anticipated obstacles.

 

Conclusions: Potential barriers to greater readiness for implementing the ADAPT CP included contextual factors, lack of ownership and less clarity around strategies to support implementation. Targeting such issues in services with mid-range or low organisational readiness for change at baseline may improve staff confidence and ability to successfully implement psycho-oncology focused interventions.