Article Text
Abstract
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.
- oncology
- health services administration & management
- qualitative research
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Footnotes
Twitter @S_A_Richmond
Contributors Conceptualisation: RU, CK, EC, BJP, GK, SAR and JLB. Methodology: RU, LLM, CK, EC, BJP, GK, SAR and JLB. Formal analysis: RU, LLM. Writing–original draft preparation: RU. Writing–review and editing: RU, LLM, CK, EC, BJP, GK, SAR and JLB. Funding acquisition: RU, CK, EC, BJP, GK, SAR and JLB. All authors read and approved the final manuscript.
Funding The work was supported by a research grant from the Canadian Cancer Society Research Institute (grant number 704897). BJP was supported in part by the US National Institute of Mental Health (K01MH113806; BJP, PI) and the US National Cancer Institute (P50CA244431; Brownson, PI).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study was approved by the Nova Scotia Health Authority’s Research Ethics Board. All participants provided written informed consent before participating in the study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available. This is a qualitative data set and therefore not publicly available due to confidentiality reasons.
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