A qualitative evaluation of the process of creating and implementing an interprofessional care pathway for patients treated with oral anticancer drugs

Abstract

Purpose

To investigate factors affecting the cocreation and implementation of care pathways for patients treated with oral anticancer drugs.

Methods

An explorative qualitative process evaluation was performed at four Belgian hospitals, cocreating and implementing a care pathway for patients on oral anticancer drugs. Semistructured interviews and focus groups were performed by a) local coordinators leading an interprofessional project team during the cocreation and implementation stage, b) external implementation coaches, and c) teams of healthcare professionals with a role in the care pathway. In total, 47 stakeholders were interviewed. Interviews were audio-taped, transcribed verbatim, and analyzed thematically.

Results

We found four factors affecting cocreation and implementation of care pathways for patients on oral anticancer drugs. Developing an adequate supporting context using motivated interprofessional project teams of clinical and management staff led by competent coordinators is one important facilitator. Leadership of local coordinators and oncologists is crucial for progressing the cocreation. Other factors included the complexity of the oral anticancer drug intervention, the interprofessional character of the care pathway, and involving primary care. External coaching during cocreation proved an important facilitator.

Conclusions

Prior investigation of willingness and motivation to change in clinical and management staff, competent coordinators, and leadership of oncologists are needed. In addition, external support determines the success of cocreating and implementing care pathways for patients on oral anticancer drugs.