Evidence-Informed public health practice:
Knowledge Translation in Colon and Rectal Cancer in LHIN4 (KTCC-L4)
Researchers often identify ‘quality gaps’ in the health care delivered to patients. These are stages during treatment where a patient receives suboptimal care. The quality of cancer surgery varies according to what techniques and practices are used, and certain activities prevent quality gaps from arising.
Surgeons selected the following activities as markers of a subsequent high quality surgery. Patients who:
- Receive pre-operative imaging of the abdomen with CT or MRI (colon/rectal cancer)
- Receive pre-operative imaging of the pelvis with CT or MRI (rectal cancer)
- Undergo pathologic assessment of the tumour-radial margin distance (rectal cancer)
The Knowledge Translation in Colon and Rectal Cancer in LHIN4 (KTCC-L4) Project aims to improve surgical outcomes by targeting these quality markers. They describe a three pronged KT intervention:
1. Audit and feedback with surgeons
a. Hospitals are audited for rates of occurrence of the quality markers.
b. Workshops are held with surgeons to present the importance of the quality markers, and to solicit feedback.
2. Tailoring process with surgeons and potentially other stakeholders
a. This is an effort to change the actions of surgeons, encouraging them to use these different techniques.
b. Barriers to adoption of new techniques are identified at different levels (individual, social, organizational), and addressed.
3. Deliberative processes with researchers, the public, administrators and policy makers
a. Separate deliberative processes are held with administrators and policy makers, and with representatives of the public.
b. Each provides an overview of the project, a summary of the evidence linking the markers to care, discussion of the usefulness of KT interventions (i.e. audit and feedback), and a survey.
c. These deliberative processes inform the usability of engaging non-clinician groups in a KT intervention.
Knowledge Translation at McMaster
These methods are used to assess, alter and evaluate the markers of quality care in colorectal and rectal surgeries. This research project aims to educate surgeons and change their practices to better facilitate quality care. In terms of knowledge translation, the project is identifying barriers to the uptake of relevant information by surgeons, and developing strategies to address those barriers.
KT interventions can take the form of a broad range of activities, and have a broad range of focuses. Clinical interventions are a single aspect of KT research and services, and enhancing surgery is a very specific way that KT interventions can be applied to address the movement of knowledge, and improve patient care.
Dr. Marko Simunovic< firstname.lastname@example.org>