Identifying factors influencing sustainability of innovations in cancer survivorship care: a qualitative study

• Published in: BMJ open Vol. 11; no. 2; p. e042503
• Main Authors: Urquhart, Robin, Kendell, Cynthia, Cornelissen, Evelyn, Powell, Byron J, Madden, Laura L, Kissmann, Glenn, Richmond, Sarah A, Bender, Jacqueline L
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 05.02.2021; BMJ Publishing Group
• Series: Original research
• Subjects: Canada; Cancer; Data analysis; Data collection; Delivery of Health Care; Health Services Research; Humans; Innovations; Interviews; Medical research; Neoplasms - therapy; Qualitative Research; Survivor; Survivorship; Sustainability; Taxonomy; Canada; oncology; health services administration & management; qualitative research
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-042503

ObjectivesMoving innovations into healthcare organisations to increase positive health outcomes remains a significant challenge. Even when knowledge and tools are adopted, they often fail to become integrated into the long-term routines of organisations. The objective of this study was to identify factors and processes influencing the sustainability of innovations in cancer survivorship care.DesignQualitative study using semistructured, in-depth interviews, informed by grounded theory. Data were collected and analysed concurrently using constant comparative analysis.Setting25 cancer survivorship innovations based in six Canadian provinces.ParticipantsTwenty-seven implementation leaders and relevant staff from across Canada involved in the implementation of innovations in cancer survivorship.ResultsThe findings were categorised according to determinants, processes and implementation outcomes, and whether a factor was necessary to sustainability, or important but not necessary. Seven determinants, six processes and three implementation outcomes were perceived to influence sustainability. The necessary determinants were (1) management support; (2) organisational and system-level priorities; and (3) key people and expertise. Necessary processes were (4) innovation adaptation; (5) stakeholder engagement; and (6) ongoing education and training. The only necessary implementation outcome was (7) widespread staff and organisational buy-in for the innovation.ConclusionsFactors influencing the sustainability of cancer survivorship innovations exist across multiple levels of the health system and are often interdependent. Study findings may be used by implementation teams to plan for sustainability from the beginning of innovation adoption initiatives.