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Bridging Operative Standards to Clinical Practice: A Case Comparison of Synoptic Operative Report Implementation in

Meagan Elam1, Jamie Hillas1,2, Rachel Moyal-Smith1,3

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Summary

The Commission on Cancer (CoC) mandated synoptic operative reporting (SOR) for breast cancer care. Implementation challenges included cost, complexity, and varying informatics support, highlighting the need for tailored CoC technical assistance.

Keywords:
Accreditation standardBreast cancer surgeryCommission on cancerConsolidated framework for implementation researchImplementation scienceSynoptic operative report

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Area of Science:

  • Oncology
  • Healthcare Informatics
  • Quality Improvement

Background:

  • The Commission on Cancer (CoC) mandated synoptic operative reporting (SOR) in 2020 to enhance guideline-concordant breast cancer care.
  • This study examines the implementation of breast cancer SOR across four accredited sites.

Purpose of the Study:

  • To identify common challenges in implementing breast cancer synoptic operative reporting (SOR).
  • To provide recommendations for the Commission on Cancer (CoC) to address these implementation barriers.

Main Methods:

  • A case-comparison study involving semi-structured interviews with 31 stakeholders.
  • Utilized the Consolidated Framework for Implementation Research for thematic analysis across NCI-Designated Cancer Programs and Comprehensive Community Cancer Programs.

Main Results:

  • The CoC was the primary driver for SOR implementation, with concerns about cost and complexity.
  • Cancer liaison physicians and information technology were critical; surgeons faced workflow challenges.
  • Standardization and data collection were seen as beneficial but not essential, leading to low motivation for change.

Conclusions:

  • Cancer liaison physicians are crucial champions for SOR implementation.
  • The CoC should offer tailored technical support to mitigate costs, complexity, and varying informatics resources.