Related Experiment Video
Updated: Oct 5, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Barriers to high-quality rectal cancer care: A qualitative study
Samantha Hendren1, Arielle E Kanters1, Arden M Morris2
1Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Background:
High quality multidisciplinary care improves outcomes for rectal cancer (RC) but is not consistently provided. Our objective was to understand surgeons' barriers to RC care.
Methods:
Semi-structured interviews were conducted with 18 surgeons from 10 Michigan hospitals. Reports of hospital performance were shared. Interview transcripts were dual coded; data were reduced into emergent themes; and disagreements were resolved by discussion.
Results:
Barriers to high quality care included negative attitudes, (resistance to change; not taking responsibility) lack of training/experience, complex care coordination, and financial disincentives. Facilitators included providers' positive attitudes and relationships, training/experience, surgeon leadership (development of protocols), patient-level systems of care (patient navigator), and higher-level support (cancer center reviews quality data). Themes were incorporated into an explanatory framework, with patient, provider, and systems domains.
Conclusions:
In this qualitative study of RC surgeons, we identified barriers to and facilitators of high-quality care. The framework developed will facilitate the design of quality improvement interventions.
More Related Videos
08:26Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
03:43Structured Approach to Colonoscopy Technique Optimization: A Single-Center Experience with Novice Endoscopists
Published on: July 11, 2025
Related Concept Videos
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...