A mixed methods evaluation of the Canopy Cancer Collective’s implementation of network-wide screening initiative in 2023.
Authors: Priya Pathak, Emily J Martin, Elizabeth Ann Kvale, Bobby Korah, Amy Hacker-Prietz, Revathi Myneni, Amol Narang, Joseph M. Herman, Carrie Tompkins Stricker
Journal: Journal of Clinical Oncology (2025)

709 Background: The Canopy Cancer Collective, a Learning Health Network (LHN) comprised of 14 pancreatic cancer centers across the U.S., set ambitious goals in 2023 to improve screening rates across four key areas: clinical trial screening (from a baseline of 30% to 100%), assessment of enzyme replacement (37% to 100%), goals of care discussions (57% to 100%), and palliative care screening (30% to 100%). This study aimed to identify the barriers and facilitators influencing the implementation of these screening aims, with the goal of developing informed, actionable recommendations for future implementation efforts. Methods: Throughout 2023, data were gathered from monthly assessments completed by site coordinators and quality improvement coaches at each of the 14 centers. These assessments captured insights into planning, implementation, and challenges related to the screening aims. Additionally, a comprehensive site assessment conducted in October 2023 was analyzed. We employed content analysis to identify the key factors influencing the implementation process, with percentage improvements in screening aims documented. Results: A total of 128 assessments were reviewed. The most common barriers identified were insufficient personnel and time for screening implementation (n=7), delayed responses and lack of engagement from supporting teams (n=6), unanticipated delays and logistical barriers to the procedures (n=6), recruitment challenges (n=3), and changes in the staff or management (n=5). Facilitators that supported implementation included: identification and testing of patient-centered strategies for implementation of screening (n=11), team expansion (n=8), consistent data collection and sharing through the LHN database (n=7), launching of other initiatives tailored to institutional needs (n=5), and collaboration between teams within or across institutions (n=4). Among the barriers to form ideal interprofessional composition, resource shortages (n=7), provider shortages (n=6), and coordination difficulties (n=5) were included. By January 2024, the network’s screening rates had improved significantly: 92% for clinical trial, 87% for enzyme need and palliative care each, and 97% for goals of care. Conclusions: While common challenges such as staffing limitations and logistical barriers posed obstacles, facilitators like patient-centered strategies, team growth, and improved collaboration were key to the successful implementation of the screening aims. These findings offer actionable insights for enhancing future implementation efforts, with a focus on addressing resource limitations and fostering team engagement. Moving forward, we plan to assess the outcomes of these screening initiatives to examine their impact on patient care and evaluate the perceptions of site on utilization of implementation strategies to promote its adoption.