Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Optimal delivery of cancer Clinical Quality Registries in the Australian setting: identifying elements through stakeholder interviews (#470)

Ashleigh R Sharman 1 2 , Jonathan R Clark 2 3 4 , Rebecca L Venchiarutti 1 2
  1. Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia
  2. Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
  3. Central Clinical School, The University of Sydney, Camperdown, NSW, Australia
  4. Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW, Australia

Aims

Several clinical quality registries (CQRs) exist in Australia which aim to improve cancer outcomes by ensuring patient centred, high-quality, evidence-based care that optimises value to the healthcare system. This study aimed to identify the means to successful implementation of CQRs in Australia by identifying barriers and facilitators of implementation and sustainability, and drivers of acceptability and feasibility.

Methods

Semi-structured interviews were conducted with stakeholders (n=20) including directors, program leads, data managers, or other staff involved in implementation or management of CQRs listed on the Australian Register of Clinical Registries. Participants were purposively recruited from CQRs listed under ‘high burden cancers’ (n=15) and others from participant recommendations of current best-practice CQRs (n=5). Recruitment continued until thematic saturation was achieved across each participant group. Interviews were conducted and recorded via videoconferencing and audio files transcribed. A qualitative approach was used to map themes to the Consolidated Framework for Implementation Research using NVivo.

Results

Participants identified a wide range of feasibility and implementation challenges for CQRs, with some questioning the ability of a CQR to facilitate clinical change. Topics identified were mapped to CFIR constructs, of which ‘innovation complexity’, ‘innovation design’, ‘tension for change’, ‘communication’, ‘funding’ and ‘mission alignment’ were most salient. Participants strongly advocated for streamlined ethics and governance processes, appropriate IT infrastructure, sustainable funding, and workforce allocation. Stakeholders readily identified the ongoing success of a CQR can be influenced by several factors including lack of funding, low data quality, poor stakeholder motivation and lack of training. Practical strategies to address implementation challenges and to provide ongoing support of CQRs included developing a community of practice, clear training and guidelines, instating clinical champions, and appropriate pre-planning.

Conclusions

Guidance to better support organisational oversight, management and CQR operations will further strengthen and support successful implementation of CQRs for cancer in the future.