Effective Communication for Preventing and Responding to Oncology Adverse Events
Condition: Cancer
Study type: Interventional

Summary: 
      Cancer patients often experience problems in their care, many of which are caused by
      communication breakdowns. Some communication breakdowns lead to adverse events and even
      harmful errors. Deficiencies in provider-patient communication can compound patients'
      distress, lower the quality of care, and disrupt patient-provider relationships. There is
      little research on patients' and providers' experiences of the communication breakdowns that
      precipitate adverse events and errors, or on effective responses to these events. Because of
      this, cancer providers are unsure how to communicate with patients in these difficult
      situations. The goal of the proposed study is to improve patient-centered communication
      around adverse events and errors in cancer care. Our specific aims are: 1) To describe
      patients' experiences with communication around adverse events and errors in cancer care, 2)
      To describe providers' experiences and practices with communication around adverse events and
      errors in cancer care, 3) To develop practical recommendations, provider training materials
      and patient educational materials for improving communication around adverse events and
      errors in cancer care, 4) To disseminate the recommendations and materials through three
      health plans, and 5) To conduct a preliminary evaluation of the perceived usefulness and
      impact of the materials. The investigators will first conduct interviews with breast and
      colorectal cancer patients who have experienced adverse events or errors at 3 Cancer Research
      Network (CRN) health plans (Atlanta, Georgia; Seattle, Washington and Worcester,
      Massachusetts). The interviews will focus on instances where patients believe that better
      communication might have prevented an adverse event or error, or mitigated the event's
      impact. Next the investigators will conduct focus groups to understand providers' attitudes
      and experiences with these communication dilemmas, and use simulations to describe providers'
      communication practices. Finally, the investigators will interview health plan leaders to
      identify the systems factors that influence communication with patients around adverse events
      and errors. These perspectives will be synthesized to create patient and provider educational
      material for improving communication. Three advisory panels: a Patient Advisory Panel, a
      Health Plan Advisory Panel and a Dissemination Advisory Panel (including all 14 CRN health
      plans) will help create and disseminate these educational interventions. Dissemination will
      occur at the three core clinical sites. The investigators use patient and provider surveys to
      evaluate the educational materials' impact. This evaluation will provide the evidence-base to
      refine the study products before widespread dissemination throughout the CRN and beyond. The
      project will have the advantage of the CRN infrastructure, the CRN Clinical Communication
      Research Center, and is led by nationally recognized communication researchers.
    


Intervention name(s): "We Want to Know" campaign, Patient survey at 2 time points
Intervention type(s): Other
Intervention description(s): Randomly assigned patients attending cancer clinics at Washington or Georgia sites during February 2013 to August 2013 will be presented with or mailed a survey about cancer communication approximately 2 weeks later and a follow-up survey approximately 3 months later. Additionally, this group will also receive a follow-up phone call approximately 4 weeks after baseline survey.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Health Services Research