EPOCK study protocol: a mixed-methods research program evaluating cancer care coordination nursing occupations in France as a complex intervention

F Colombani, M Sibé, M Kret, B Quintard, A Ravaud, F Saillour-Glénisson, F Colombani, M Sibé, M Kret, B Quintard, A Ravaud, F Saillour-Glénisson

Abstract

Background: Facing the increasing cancer incidence and cancer survivorship, many national strategic cancer plans have identified cancer care coordination as a priority for health service improvement. However, the high variability of practices, the diversity of definitions and underlying concepts increases the existing difficulty to standardise, replicate, transpose and assess care coordination within the French health system context. The EPOCK national study aims at evaluating practices and the working context of hospital-based cancer care coordination nurses, based on a previously designed reference framework for care coordination within the French health system context.

Methods: EPOCK is based on a comprehensive evaluation of nursing professions in cancer care coordination, considered as a complex intervention. Phase 1 (theoretical phase) will define and design a theoretical reference framework for care coordination in France through an international literature review, aiming to identify relevant models and all components of the expected framework and a structured consensus method, the Nominal group technique, aiming to select and prioritise the most relevant components already found in the literature review with regard to the French healthcare system; phase 2 (Operational phase) will consist in an in-depth analysis of practices, contexts, perceptions and attitudes related to care coordination occupations by nurses in oncology and all stakeholders (related professionals, patients and their caregivers) through a multicentric cross-sectional mixed-method evaluative study. The observed practices and contexts will be finally compared with the theoretical reference framework using both inductive and deductive approaches.

Discussion: This study will result in an evaluation framework identifying key models and key elements relative to cancer care coordination interventions that can be used to guide management of cancer care coordination nursing occupations within the French healthcare system. EPOCK would also assist in public decision-making to identify optimal targets, skills profiles and scope of actions for cancer coordination professions. Finally, EPOCK will describe typology of nurse practices in cancer care coordination and thus obtain precise preliminary information essential for drafting a medico-economic evaluation study of these new nursing professions' impact.

Trial registration: Clinicaltrial.gov registration: NCT03350776 , 11/22/2017.

Keywords: Care coordination; Continuity of patient care; Models; Neoplasms; Nurses; Organisational context; Patient care management; Patient-centered care; Theoretical framework.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Epock study protocol flow chart, France

References

    1. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007;297(8):831–841.
    1. Osborn R, Moulds D, Squires D, Doty MM, Anderson C. International survey of older adults finds shortcomings in access, coordination, and patient-centered care. Health Aff (Millwood) 2014;33(12):2247–2255.
    1. Borgermans L, Marchal Y, Busetto L, Kalseth J, Kasteng F, Suija K, et al. How to improve integrated Care for People with chronic conditions: key Findings from EU FP-7 project INTEGRATE and beyond. Int J Integr Care. 2017;17(4):7.
    1. WHO | Global status report on noncommunicable diseases 2010. Description of the global burden of NCDs, their risk factors and determinants. World Health Organization. April 2011.
    1. Young JM, Walsh J, Butow PN, Solomon MJ, Shaw J. Measuring cancer care coordination: development and validation of a questionnaire for patients. BMC Cancer. 2011;11:298.
    1. Haggerty JL, Reid RJ, Freeman GK, Starfield BH, Adair CE, McKendry R. Continuity of care: a multidisciplinary review. BMJ. 2003;327(7425):1219–1221.
    1. Guthrie B, Saultz JW, Freeman GK, Haggerty JL. Continuity of care matters. BMJ. 2008;337:a867.
    1. Nazareth I, Jones L, Irving A, Aslett H, Ramsay A, Richardson A, et al. Perceived concepts of continuity of care in people with colorectal and breast cancer--a qualitative case study analysis. Eur J Cancer Care (Engl) 2008;17(6):569–577.
    1. Bodenheimer T. Coordinating care--a perilous journey through the health care system. N Engl J Med. 2008;358(10):1064–1071.
    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
    1. Kelly RJ, Smith TJ. Delivering maximum clinical benefit at an affordable price: engaging stakeholders in cancer care. Lancet Oncol. 2014;15(3):e112–e118.
    1. Pesec M, Sherertz T. Global health from a cancer care perspective. Future Oncol. 2015;11(15):2235–2245.
    1. Baili P, Di Salvo F, Marcos-Gragera R, Siesling S, Mallone S, Santaquilani M, et al. Age and case mix-standardised survival for all cancer patients in Europe 1999–2007: results of EUROCARE-5, a population-based study. Eur J Cancer. 2015;51(15):2120–2129.
    1. Phillips JL, Currow DC. Cancer as a chronic disease. Collegian. 2010;17(2):47–50.
    1. Walsh J, Young JM, Harrison JD, Butow PN, Solomon MJ, Masya L, et al. What is important in cancer care coordination? A qualitative investigation. Eur J Cancer Care. 2011;20(2):220–227.
    1. Haynes K, Ugalde A, Whiffen R, Rogers M, Duffy M, Packer C, et al. Health professionals involved in cancer care coordination: nature of the role and scope of practice. Collegian. 2018;25(4):395–400.
    1. Global Burden of Disease Cancer Collaboration. Fitzmaurice C, Allen C, Barber RM, Barregard L, Bhutta ZA, et al. Global, regional, and National Cancer Incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 Cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol. 2017;3(4):524–548.
    1. Gorin SS, Haggstrom D, Han PKJ, Fairfield KM, Krebs P, Clauser SB. Cancer care coordination: a systematic review and meta-analysis of over 30 years of empirical studies. Ann Behav Med. 2017;51(4):532–546.
    1. Yates P. Cancer care coordinators: Realising the potential for improving the patient journey. Cancer Forum. 2004;28(3):128–132.
    1. McDonald KM, Sundaram V, Bravata DM, Lewis R, Lin N, Kraft SA, et al. Closing the quality gap: a critical analysis of quality improvement strategies (Vol. 7: care coordination). Rockville: Agency for Healthcare Research and Quality (US); 2007. (AHRQ Technical Reviews).
    1. Easley J, Miedema B, Carroll JC, O’Brien MA, Manca DP, Grunfeld E. Patients’ experiences with continuity of cancer care in Canada: results from the CanIMPACT study. Can Fam Physician. 2016;62(10):821–827.
    1. Armitage GD, Suter E, Oelke ND, Adair CE. Health systems integration: state of the evidence. Int J Integr Care. 2009;9(2).
    1. Mc Donald KM. AHRQ updates on primary care research: care coordination measures atlas and database. Ann Fam Med. 2014;12(5):484.
    1. Integrated care models: an overview. Working document. Denmark: World Health Organization regional office for Europe; 2016 p. 42.
    1. Langan M. Community care in the 1990s: the community care White paper: ‘caring for people. Crit Soc Policy. 1990;10(29):58–70.
    1. Wagner EH. Chronic disease management: what will it take to improve care for chronic illness? Eff Clin Pract. 1998;1(1):2–4.
    1. Grover A, Joshi A. An overview of chronic disease models: a systematic literature review. Global J Health Sci. 2015;7(2):210.
    1. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20(6):64–78.
    1. Case Management Society UK. CMSUK standards and best practice guidelines. 2009. Report no.: 2nd edition.
    1. Fisher HM, McCabe S. Managing chronic conditions for elderly adults: the VNS CHOICE model. Health Care Financ Rev. 2005;27(1):33–45.
    1. Huxley P. Case management and Care Management in Community Care. Br J Soc Work. 1993;23(4):365–381.
    1. Leutz WN. Five laws for integrating medical and social services: lessons from the United States and the United Kingdom. Milbank Q. 1999;77(1):77–110.
    1. Dunbar J, Reddy P. Integration and coordination of care. Aust J Rural Health. 2009;17(1):27–33.
    1. Wagner EH. Chronic disease care. BMJ. 2004;328(7433):177–178.
    1. Bates DW. Health information technology and care coordination: the next big opportunity for informatics? Yearb Med Inform. 2015;10(1):11–14.
    1. Lawal AK, Rotter T, Kinsman L, Machotta A, Ronellenfitsch U, Scott SD, et al. What is a clinical pathway? Refinement of an operational definition to identify clinical pathway studies for a Cochrane systematic review. BMC Med. 2016;14:35.
    1. Freeman HP. Patient navigation: a community based strategy to reduce cancer disparities. J Urban Health. 2006;83(2):139–141.
    1. Wells KJ, Battaglia TA, Dudley DJ, Garcia R, Greene A, Calhoun E, et al. Patient navigation. Cancer. 2008;113(8):1999–2010.
    1. Dohan D, Schrag D. Using navigators to improve care of underserved patients: current practices and approaches. Cancer. 2005;104(4):848–855.
    1. Rich EC, Lipson D, Libersky J, Peikes DN, Parchman ML. Organizing care for complex patients in the patient-centered medical home. Ann Fam Med. 2012;10(1):60–62.
    1. Peikes D, Zutshi A, Genevro J, Smith K, Parchman M, Meyers D. Early evidence on the patient-centered medical home. Final report. Rockville: Agency for Healthcare Research and Quality (AHRQ) publication; 2012. (No. 12-0020-EF)
    1. Kline RM, Bazell C, Smith E, Schumacher H, Rajkumar R, Conway PH. Centers for medicare and medicaid services: using an episode-based payment model to improve oncology care. J Oncol Pract. 2015;11(2):114–116.
    1. Feld D. Soins. 2016;61(806):29–31.
    1. Freeman HP, Rodriguez RL. The history and principles of patient navigation. Cancer. 2011;117(15 0):3539–3542.
    1. Hisashige A. The effectiveness and efficiency of disease management programs for patients with chronic diseases. Glob J Health Sci. 2013;5(2):27–48.
    1. RAND Europe. National Evaluation of the Department of Health’s Integrated Care Pilots. Cambridge: RAND Corporation.
    1. Tomasone JR, Brouwers MC, Vukmirovic M, Grunfeld E, O’Brien MA, Urquhart R, et al. Interventions to improve care coordination between primary healthcare and oncology care providers: a systematic review. ESMO Open. 2016;1(5):e000077.
    1. Tomasone JR, Vukmirovic M, Brouwers MC, Grunfeld E, Urquhart R, O’Brien MA, et al. Challenges and insights in implementing coordinated care between oncology and primary care providers: a Canadian perspective. Curr Oncol. 2017;24(2):120–123.
    1. Geneva: World Health Organization. Continuity and coordination of care: a practice brief to support implementation of the WHO framework on integrated people-centred health services 2018. WHO regional office for Europe; 2018. Report No.: Licence: CC BY-NC-SA 3.0 IGO.
    1. Moore GF, Audrey S, Barker M, Bond L, Bonell C, Hardeman W, et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ. 2015;350:h1258.
    1. Rankin NM, McGregor D, Butow PN, White K, Phillips JL, Young JM, et al. Adapting the nominal group technique for priority setting of evidence-practice gaps in implementation science. BMC Med Res Methodol. 2016;16:110.
    1. Rashid A, Thomas V, Shaw T, Leng G. Patient and public involvement in the development of healthcare guidance: an overview of current methods and future challenges. Patient. 2017;10(3):277–282.
    1. Skrutkowski M, Saucier A, Eades M, Swidzinski M, Ritchie J, Marchionni C, et al. Impact of a pivot nurse in oncology on patients with lung or breast cancer: symptom distress, fatigue, quality of life, and use of healthcare resources. Oncol Nurs Forum. 2008;35(6):948–954.
    1. Skrutkowski M, Saucier A, Ritchie JA, Tran N, Smith K. Intervention patterns of pivot nurses in oncology. Can Oncol Nurs J. 2011;21(4):218–227.
    1. Compaci G, Ysebaert L, Obéric L, Derumeaux H, Laurent G. Effectiveness of telephone support during chemotherapy in patients with diffuse large B cell lymphoma: the ambulatory medical assistance (AMA) experience. Int J Nurs Stud. 2011;48(8):926–932.
    1. Compaci G, Rueter M, Lamy S, Oberic L, Recher C, Lapeyre-Mestre M, et al. Ambulatory medical assistance--after Cancer (AMA-AC): a model for an early trajectory survivorship survey of lymphoma patients treated with anthracycline-based chemotherapy. BMC Cancer. 2015;15:781.
    1. Eisenberger R, Huntington R, Hutchison S, Sowa D. Perceived organizational support. J Appl Psychol. 1986;71(3):500.
    1. Allen NJ, Meyer JP. Special issue loyalty in a multi-commitment WorldOrganizational commitment: evidence of career stage effects? J Bus Res. 1993;26(1):49–61.
    1. Allen NJ, Meyer JP. The measurement and antecedents of affective, continuance and normative commitment to the organization. J Occup Psychol. 1990;63(1):1–18.
    1. Résultats des expérimentations du parcours personnalisé des patients pendant et après le cancer, rapport d’évaluation. Collection Bilans d’activité et d’évaluation, ouvrage édité par l’INCa, Boulogne-Billancourt, septembre 2012.
    1. Nolte S, Liegl G, Petersen MA, Aaronson NK, Costantini A, Fayers PM, et al. General population normative data for the EORTC QLQ-C30 health-related quality of life questionnaire based on 15,386 persons across 13 European countries, Canada and the Unites States. Eur J Cancer. 2019;1;107:153–63.
    1. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–655.
    1. Higginson IJ, Gao W. Caregiver assessment of patients with advanced cancer: concordance with patients, effect of burden and positivity. Health Qual Life Outcomes. 2008;6:42.
    1. Belgacem B, Auclair C, Fedor M-C, Brugnon D, Blanquet M, Tournilhac O, et al. A caregiver educational program improves quality of life and burden for cancer patients and their caregivers: a randomised clinical trial. Eur J Oncol Nurs. 2013;17(6):870–876.
    1. Labbe E, Blanquet M, Gerbaud L, Poirier G, Sass C, Vendittelli F, et al. A new reliable index to measure individual deprivation: the EPICES score. Eur J Pub Health. 2015;25(4):604–609.
    1. International Classification of Diseases (ICD) 10th revision: 2010. Available from: . [cited 2019 Mar 3].
    1. Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, et al. The eighth edition AJCC Cancer staging manual: continuing to build a bridge from a population-based to a more ‘personalized’ approach to cancer staging. CA Cancer J Clin. 2017;67(2):93–99.
    1. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357.
    1. Commeiras N, Loubès A, Fournier C. Les effets des tensions de rôle sur l’implication au travail : une étude auprès des managers de rayon. mi. 2009;13(4):73–89.
    1. Hox JJ. From theoretical concept to survey question. In: Survey measurement and process quality: Wiley; 2012. p. 47–69.
    1. Locke EA. Theory building, replication, and behavioral priming: where do we need to go from here? Perspect Psychol Sci. 2015;10(3):408–414.
    1. Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320(7227):114–116.
    1. Clark AM. What are the components of complex interventions in healthcare? Theorizing approaches to parts, powers and the whole intervention. Soc Sci Med. 2013;93:185–193.
    1. Datta J, Petticrew M. Challenges to evaluating complex interventions: a content analysis of published papers. BMC Public Health. 2013;13:568.

Source: PubMed

3
Tilaa