Table 4

Summary of key activities by project phase captured in project data log

Strategies*Key activitiesOutcomes
Preimplementation (October 2014–April 2015)
Assess for readiness and identify barriers and facilitators
  • Focused literature review: implementation strategies using templates in oncology

  • Review highlighted lack of lung cancer studies using templates

  • Review examples of hospital reporting templates within organisation; review generic example from primary care

  • Review notes that useful templates are integrated into eMR system

Conduct local needs assessment
  • Conduct process mapping to identify gaps in lung cancer MDT information and communication provision

  • Process mapping highlighted lack of systematic reporting to GPs apart from medical specialist letters

Build a coalition/conduct educational meetings
  • Discuss staff roles and responsibilities for template completion (project officer, specialist nurses, registrars and chairperson)

  • Team identified that registrars would complete majority of items and clinical staff required to sign off

Develop a formal implementation blueprint
  • Project protocol and methodology documented

  • Protocol written to document project aims and methods

  • Human Research Ethics Committee approval granted

  • Ethics clearance gained to facilitate publication of results

Provide local technical assistance
  • Request submitted to SLHD Information Management and Technology Division (IM&TD) to initiate project

  • Project complies with policy requirements to receive in-house IM&TD development support

Prepare patients/consumers to be active participants
  • Draft lung MDT template developed and reviewed by MDT, GPs and consumers

  • Core team determines items for inclusion through consultation

Develop and implement tools for quality monitoring
  • Development of survey instrument for the evaluation component

  • Evaluation survey mapped to theoretical approach (Proctor et al 30)

  • Template finalised and built into Cerner PowerChart by IM&TD

  • Final checks to align selected items with source data within Cerner

Conduct ongoing training
  • IM&TD provides training for clinical staff in template use including data migration

  • IM&TD staff train registrars, project officer and specialist nurse

Conduct educational meetings
  • Clinical leadership forum held to promote implementation of the template

  • Leaders from project sites engage in group discussion

Implementation (May 2015–May 2016)
Mandate change,
revise professional roles
  • Lung MDT template ‘launched’ across SLHD by local champions

  • All MDT members informed about template use and MDT Chairs note this during weekly MDT meetings

Implement tools for quality monitoring
  • Templates and study documents sent to individual GPs within 48 hours of MDT meeting conclusion

  • Project officer and nurse specialist confirm data and send out template to GPs for 56-week period

Data collection
  • Evaluation survey administered by telephone with GPs begin

  • Concurrent weekly data collection via phone call with consenting GPs

  • Ongoing data collection and database management

  • Project officer enters GP evaluation data following survey completion

  • Project officer logs team discussion about efficiencies in completing patient data

  • Preliminary results analysed and presented at local meetings

  • Initial data tabulated and summary results presented to team, cancer services staff within the LHD

Evaluation (June 2016–December 2016)
  • Evaluation surveys completed, data entered and cleaned

  • All data entered and anomalies corrected; generate results tables; coding of qualitative responses

  • Data analysis and summary reporting, preparation of conference abstracts

  • Data analysed and interpreted, project results prepared as an abstract and presentation slides

  • Sustainability of reporting process discussed by SLHD representatives and research team

  • Team engages with cancer services team to discuss sustainability of the project and potential adaptation for other tumour streams

  • *Strategies as listed in the Expert Recommendations for Implementing Change implementation strategy compilation.31

  • eMR, electronic medical record; GP, general practitioner; LHD, local health district; MDT, multidisciplinary team; SLHD, Sydney Local Health District.