Implementing a standardised perioperative nutrition care pathway in upper gastrointestinal cancer surgery: a mixed-methods analysis of implementation using the Consolidated Framework for Implementation Research

• DOI: 10.1186/s12913-022-07466-9
• Publication Date: 2022-02-25T04:45:14Z
• Authors: Irene Deftereos; Danielle Hitch; Sally Butzkueven; Vanessa Carter; Kate Fetterplace; Kate Fox; Aurora Ottaway; Kathryn Pierce; Belinda Steer; Jessie Varghese; Nicole Kiss; Justin M Yeung
• Keywords: Implementation research; Health administration; Health Services Research

Implementation studies of complex interventions such as nutrition care pathways are important to health services research, they support translation research into practice. There is limited regarding implementation a pathway in an upper gastrointestinal (UGI) cancer population. The aim this study was comprehensively evaluate the process perioperative UGI surgery using Consolidated Framework for Research (CFIR).This mixed methods conducted during pilot standardised across four major hospitals between September 2018 August 2019. Outcome measures included five focus groups among dietitians (n = 4-8 per group), and quantitative satisfaction surveys from multi-disciplinary team (MDT) members 14) patients 18). Focus group responses were analysed thematically CFIR constructs, which used priori codes. Survey summarised means standard deviations. A convergent parallel approach according domains constructs integrate qualitative data.Qualitative data demonstrated that dietitian perceptions primarily aligned with (networks communications, structural characteristics, adaptability, compatibility patient needs/resources), indicating clinical environment. Challenges mostly related adapting pathway, coordination existing aspects within each setting. Identified benefits MDT survey increased engagement MDT, more proactive care. Patients highly satisfied service, majority items being rated (≥4 possible 5 points).The perceived be beneficial by key stakeholders. Based on findings, sustainability compliance model may achieved improved systems level communication.