Nationwide Implementation of Standardized Structured Reporting

Study Overview
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Brief Summary
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The first objective is to explore factors that impede or facilitate implementation of SSR in pathology (and other disciplines) among the MDT members receiving SSRs. The second objective is to select, develop and evaluate (process and effect outcomes) implementation tools supporting optimal implementation of SSR in pathology. The third objective is to offer implementation tools to all pathology laboratories in the Netherlands and to share the SSR-kit for successful implementation with other medical disciplines

Detailed Description
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By implementing SSR in various disciplines, we contribute to improving communication, efficiency and quality of multidisciplinary team (MDT) meetings and facilitate optimal treatment decision making. Optimal discussion of each patient at MDT meetings can be achieved by a clear communication of all diagnostic results among MDT members. However, the adoption of innovations, such as SSR, is laborious, especially when the innovation requires changing daily habits. Offering implementation tools supports the adoption of innovations among medical professionals. Implementation tools are most effective when they are developed on the basis of factors that impede or facilitate the innovation. Besides the importance of investigating these factors for SSR among pathologists, we will also involve MDT members receiving pathology SSRs in our study. After all, because MDT members will greatly benefit from SSR, they could play a key role in stimulating the use of SSR among pathologists. Therefore, we will also explore which tools MDT members need to stimulate the diagnostic disciplines in using SSR. Subsequently, we will develop and evaluate implementation tools to support the use of SSR by pathologists. The kit for successful implementation of SSR will be offered to other medical disciplines like radiology, endoscopy, and surgery who face similar challenges with implementation of SSR. The SSR-kit consists of our multidisciplinary approach for the whole process of developing implementation tools for SSR, examples of tools for SSR, and other results of this project.

Official Title
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Nationwide Implementation of Standardized Structured Reporting to Support Optimal Treatment Decisions

Conditions
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Standardized Structured Reporting

Intervention / Treatment
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* Behavioral: Implementation tools


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pathologists of urological, gynecological or gastro-intestinal cancers Other MDT-members of urological, gynecological or gastro-intestinal cancers (medical oncologists, radiologists, radiotherapists, urologists, gynecologists, intestinal surgeons, nuclear medicine physicians, nurse practitioners). Dutch Residents Exclusion Criteria: Retirees

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 68 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Dutch pathologists hospital I<br>Pathologists in hospital I using protocols of: Urological cancer Gynaecological cancer Gastro intestinal cancer | Behavioral: Implementation tools<br>* Implementation tools developed by experts in order to increase the use of SSR in pathology<br>|
| Dutch pathologists hospital II<br>Pathologists in hospital II using protocols of: Urological cancer Gynaecological cancer Gastro intestinal cancer | Behavioral: Implementation tools<br>* Implementation tools developed by experts in order to increase the use of SSR in pathology<br>|
| Dutch pathologists hospital III<br>Pathologists in hospital III using protocols of: Urological cancer Gynaecological cancer Gastro intestinal cancer | Behavioral: Implementation tools<br>* Implementation tools developed by experts in order to increase the use of SSR in pathology<br>|
| Dutch pathologists hospital IV<br>Pathologists in hospital IV using protocols of: Urological cancer Gynaecological cancer Gastro intestinal cancer | Behavioral: Implementation tools<br>* Implementation tools developed by experts in order to increase the use of SSR in pathology<br>|
| Dutch pathologists hospital V<br>Pathologists in hospital V using protocols of: Urological cancer Gynaecological cancer Gastro intestinal cancer | Behavioral: Implementation tools<br>* Implementation tools developed by experts in order to increase the use of SSR in pathology<br>|
| Dutch pathologists hospital VI<br>Pathologists in hospital VI using protocols of: Urological cancer Gynaecological cancer Gastro intestinal cancer | Behavioral: Implementation tools<br>* Implementation tools developed by experts in order to increase the use of SSR in pathology<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Barriers and facilitators in implementation of SSR in MDT - focus groups and self-developed questionnaire | Barriers and facilitators in implementation of SSR among MDT members measured by focus groups and a self-developed questionnaire | 9 months | 
| Effectiveness of implementation tools - frequencies of use of SSR templates in pathology in the Netherlands | The improvement in use of SSR templates in the Netherlands (=effectiveness of implementation tools) measured by frequencies of use of SSR templates in pathology (=all laboratories in the Netherlands) | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determinants of barriers and facilitators in implementation of SSR - focus groups and a self-developed questionnaire | Determinants of barriers and facilitators in implementation of SSR among MDT members measured by focus groups and a self-developed questionnaire | 1 month | 
| Experiences with implementation tools - questionnaire | Experiences of pathologists and other MDT members with the implementation tools, measured by a questionnaire | 6 months | 
| Use of implementation tools - questionnaire | Use of implementation tools among pathologists and other MDT members, measured by a questionnaire | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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standardized structured reporting, treatment decisions, multidisciplinary team, pathology, implementation tools