Grant: Operating Grant

Background: Researchers have called for new ways of improving quality in medicine. This study will evaluate the results of such an approach which has been taking place in LHIN 4, one of 14 LHINs in Ontario. The Quality Improvement in Colorectal Cancer in LHIN4 Project (QICC-L4) is designed to improve the care delivered to patients who have bowel cancer surgery. It was started in the fall of 2006 and is an example of 'integrated knowledge translation'. This means that the LHIN4 surgeons come together and select specific targets for quality improvement and the interventions to improve the selected targets. Over the last seven years, surgical leaders at Cancer Care Ontario have also been starting quality improvement projects in bowel cancer, though these are not 'integrated knowledge translation' projects. A great deal of money and energy has been used to start the QICC-L4 and the Cancer Care Ontario interventions in colorectal cancer. We would like to measure the impact of both sets of efforts. Objective:To measure if an 'integrated knowledge translation' strategy called the QICC-L4 can improve the quality of care received by patients who have bowel cancer surgery. Methods: The study will have two parts. In Part I we will interview surgeons and administrators from all of the 14 Ontario LHINs to better understand what sorts of quality improvement activities related to bowel cancer surgery have been taking place across the province. We will group LHINs that have been doing similar things. In Part II we will do a chart review of patients who underwent bowel cancer surgery in years 2006, 2009 or 2011. We will then compare measures in LHIN4 with measures in the other LHINs. Significance: Better measures in LHIN4 would provide some proof that 'integrated knowledge translation' may be a better way of improving care in bowel cancer surgery, and possibly in many other medical areas.