TY - JOUR
T1 - Readiness for implementation of lung cancer screening
T2 - A national survey of veterans affairs pulmonologists
AU - Tukey, Melissa H.
AU - Clark, Jack A.
AU - Bolton, Rendelle
AU - Kelley, Michael J.
AU - Slatore, Christopher G.
AU - Au, David H.
AU - Wiener, Renda Soylemez
N1 - Publisher Copyright:
Copyright © 2016 by the American Thoracic Society.
PY - 2016/10
Y1 - 2016/10
N2 - Rationale: To mitigate the potential harms of screening, professional societies recommend that lung cancer screening be conducted in multidisciplinary programs with the capacity to provide comprehensive care, from screening through pulmonary nodule evaluation to treatment of screen-detected cancers. The degree to which this standard can be met at the national level is unknown. Objectives: To assess the readiness of clinical facilities in a national healthcare system for implementation of comprehensive lung cancer screening programs, as compared with the ideal described in policy recommendations. Methods: This was a cross-sectional, self-administered survey of staff pulmonologists in pulmonary outpatient clinics in Veterans Health Administration facilities. Measurements and Main Results: The facility-level response rate was 84.1% (106 of 126 facilitieswith pulmonary clinics); 88.7% of facilities showed favorable provider perceptions of the evidence for lung cancer screening, and 73.6% of facilities had a favorable provider-perceived local context for screening implementation. All elements of the policyrecommendedinfrastructure forcomprehensive screeningprogramswere present in 36 of 106 facilities (34.0%); themost commondeficiencies were the lack of on-site positron emission tomography scanners or radiation oncology services. Overall, 26.5% of Veterans Health Administration facilities were ideally prepared for lung cancer screening implementation (44.1% if the policy recommendations for on-site positron emission tomography scanners and radiation oncology services were waived). Conclusions: Many facilities may be less than ideally positioned for the implementation of comprehensive lung cancer screening programs. To ensure safe, effective screening, hospitals may need to invest resources or coordinate care with facilities that can offer comprehensive care for screening through downstream evaluation and treatment of screen-detected cancers.
AB - Rationale: To mitigate the potential harms of screening, professional societies recommend that lung cancer screening be conducted in multidisciplinary programs with the capacity to provide comprehensive care, from screening through pulmonary nodule evaluation to treatment of screen-detected cancers. The degree to which this standard can be met at the national level is unknown. Objectives: To assess the readiness of clinical facilities in a national healthcare system for implementation of comprehensive lung cancer screening programs, as compared with the ideal described in policy recommendations. Methods: This was a cross-sectional, self-administered survey of staff pulmonologists in pulmonary outpatient clinics in Veterans Health Administration facilities. Measurements and Main Results: The facility-level response rate was 84.1% (106 of 126 facilitieswith pulmonary clinics); 88.7% of facilities showed favorable provider perceptions of the evidence for lung cancer screening, and 73.6% of facilities had a favorable provider-perceived local context for screening implementation. All elements of the policyrecommendedinfrastructure forcomprehensive screeningprogramswere present in 36 of 106 facilities (34.0%); themost commondeficiencies were the lack of on-site positron emission tomography scanners or radiation oncology services. Overall, 26.5% of Veterans Health Administration facilities were ideally prepared for lung cancer screening implementation (44.1% if the policy recommendations for on-site positron emission tomography scanners and radiation oncology services were waived). Conclusions: Many facilities may be less than ideally positioned for the implementation of comprehensive lung cancer screening programs. To ensure safe, effective screening, hospitals may need to invest resources or coordinate care with facilities that can offer comprehensive care for screening through downstream evaluation and treatment of screen-detected cancers.
KW - Early detection of cancer
KW - Health plan implementation
KW - Healthcare economics and organizations
KW - Lung neoplasms
KW - Surveys and questionnaires
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U2 - 10.1513/AnnalsATS.201604-294OC
DO - 10.1513/AnnalsATS.201604-294OC
M3 - Article
C2 - 27409524
AN - SCOPUS:84992630858
SN - 2325-6621
VL - 13
SP - 1794
EP - 1801
JO - Annals of the American Thoracic Society
JF - Annals of the American Thoracic Society
IS - 10
ER -