Aim: Whilst the current evidence for the benefits of supportive care screening is clear, there is a paucity of documentation on how to practically implement screening into routine clinical practice.
To investigate the factors which contribute to the implementation of supportive care screening of cancer patients and make recommendations for the integration of supportive care screening into routine clinical practice.
Methods: A stratified purposive sample of health professionals in rural and metropolitan health services involved in screening in Victoria, Australia participated in semi-structured interviews. The Promoting Action on Research Implementation in Health Services (PARIHS) framework was used to guide data collection. Thematic analysis was used to analyse the data.
Results: Twenty-five participants were interviewed. Implementation elements identified included: Leadership and Culture; local leadership involving the unit manager and implementation leaders, project officers, and support from senior management, promoted a positive culture to screening and change in clinical practice. Education; on supportive care issues for cancer patients, utilising the screening tool and strategies to aid discussion and communication were vital to building knowledge, skills and confidence in screening. Clinical experience; enriched the therapeutic conversation with patients. Participants also recognised any level of experience could use the screening tool. Clinical experience helped to facilitate champions and mentoring to support newly trained staff in screening. Policies and processes; at a state, health service and unit level needed to be place to support monitoring, documentation, communication and referral pathways. Incorporating screening into existing work flow practices addressed time issues. Auditing and data evaluation was valuable in providing feedback to staff on screening numbers and gauging workload.
Conclusions: Integrating supportive care screening into routine practice requires engagement with staff and planning at an organisational and policy level. Ensuring implementation elements are in place facilitates clinician and health service management engagement in the screening process.