Alternative catheter locking solutions in paediatric cancer care: strategies for successful implementation

 

Aim: 

To explore the implementation context of changing catheter locking solution practice in paediatric cancer care and identify appropriate strategies to enhance uptake of innovative solutions.

 

Methods: 

Qualitative multi-site study as part of a broader clinical trial (ANZCTRN: 12622000499785)1

Semi-structured interviews were undertaken with clinicians, purchasers, key decision makers (N=23) structured using the Consolidated Framework for Implementation Research (CFIR)2

The CFIR-ERIC matching tool3 was used to match implementation barriers with implementation strategies

The Cost-IS tool4 was used to determine the activities, resources and resource costs associated with each implementation strategy

 

Results: 

Based on the constructs in Figure 1, the following implementation strategies are recommended, assuming an implementation period of 2 years. Associated activities and costs are also detailed. 

1. Prepare Change Champions (USD$4,932) - 1 individual per site – 4 hours per week

2. Access Funding (USD$1,873) - Preparation of economic feasibility report

3. Build a coalition (USD$11,621) - Training on the intervention, Build an interdisciplinary team – initial weekly meetings, transitioning to monthly

4. Develop academic partnerships (USD$466) - Quarterly check in sessions with the implementation team & researchers to share recent findings

5. Promote network weaving (USD$1,837) - Meetings across wards & hospitals - initial monthly meetings, transitioning to quarterly

Total cost of implementation per hospital site: USD$20,729

 

Key Takeaways: 

Targeted efforts are needed to strengthen networks, empower change champions, and secure funding.
Providing implementation cost data allows healthcare systems to allocate the appropriate resources for efficient and sustainable implementation.