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Determining the impact of Academic Chairs program

Research updates

Issue 6, December 2010

The Academic Chairs program was designed to build leadership and skill improvement to improve cancer care and outcomes for the people of New South Wales.

The Cancer Institute NSW, in collaboration with universities and cancer services, set up six Academic Chairs to establish leadership in various fields. The aim of the Chairs is to contribute to the development of improved cancer care and outcomes for people in NSW by supporting training, capacity, research and retention within the cancer workforce.

The Academic Chairs are part of the Skilled Cancer Professionals Program, which includes 11 initiatives. These initiatives were developed in response to educational, professional and health service needs and designed to mainly build individual capacity and skill improvement for a range of cancer health professionals.

Method

The Academic Chairs were evaluated externally as part of the Skilled Cancer Professionals Program. The evaluation included a literature review, semi-structured interviews, content analysis and an online survey.

A program logic (Figure 1) was developed to determine the impact of the overall Program. The evaluation examined impacts at four levels based on Ferlie and Shortell's theory for implementing change: 1) the individual; 2) team; 3) organisation; and, 4) broader system.

Figure 1: Program Logic Model

Short, medium and long term changes were considered. Short term goals: program participation; skills and knowledge acquisition. Medium term goals: practice changes and improvements; increases in professional satisfaction and retention. Long term goals: a workforce of skilled cancer professionals to treat and support cancer patients; improved experience for cancer patients.

Results

Skilled Cancer Professionals Program - Short term changes

A total of $11,601,448 has been spent on program initiatives, supporting 410 professional development opportunities (Table 1).

The majority of the initiatives have been designed to effect change at the individual level, except for the Academic Chairs, which have been designed to build capacity across the NSW cancer system over time (Table 2).

Participants rated the Program's ability to enhance their skills and knowledge of cancer care most favourably, followed by the ability to strengthen their clinical practice and their ability to influence others to apply best practice (Figure 2). This range of impacts broadly reflect Ferlie and Shortell's framework.

Figure 2: Application of new skills by level of change (n=115)

New skills were most widely applied to the participant's clinical practice (73%); slightly less so through their team (64%) or across the organisational level (52%). An unexpected 16 per cent reported that they had an influence across the system as a result of Program involvement (Figure 3). Support from peers and senior staff at the organisation was most likely to influence the application of new skills.

Figure 3: Individual skills and knowledge developed (n=115)

Skilled Cancer Professionals program - medium/long term changes

Participants were favourable in their assessment of the initiatives and associated practice change. The most positive change reported was enhancing the ability to provide quality patient care (Figure 4).

Figure 4: Cancer professionals assessment of change in practice field (n=115)

The evaluation also highlighted that the program positively impacted on job satisfaction and contributes to the retention of skilled professionals in the cancer field. Close to three in four survey participants indicated that the program had encouraged them to remain in the cancer field.

Academic Chairs Program

The Academic Chairs Program was identified as one of the most high profile initiatives, aimed to:

• create stronger links between NSW universities and clinical practice
• establish a leading evidence base for cancer care
• promote cancer care as an attractive vocation through raising the profile of cancer care research and practice.

It has been the only program designed to have a system-wide reach. Six Chairs have been established and appointed in medical physics, radiation therapy, radiation oncology, palliative medicine, cancer nursing, and palliative nursing.

The evaluation has shown that the Academic Chairs have been actively engaged with:

• building capacity through the formation of research teams and networks
• developing a research agenda
• demonstrating leadership
• building relationships with clinicians and academics nationally/internationally
• establishing evidence based-practice and facilitating the translation of research.

While the objectives of the Chairs program will only be met over the long term, the program has been successfully established and is making progress towards long term goals. Outcomes to date include peer-reviewed publications, successful grant applications, supervision and mentoring of post-graduate students, delivery of education programs, and established links between universities and clinical settings.

The program was rated positively by respondents as it was contributing to their own work, their team, their organisation, the cancer profession and patient outcomes. Survey respondents felt strongly that the initiative was good at building the research capacity of clinicians and encouraging them to participate in continued education.

Respondents rated the initiative positively for establishing collaborations among academic and cancer care professionals, establishing collaborative links with other research institutions and supporting leadership for clinical change.

The program was also positively viewed in regard to the promotion of cancer as an important part of university programs and promotion of evidence-based practice.

Conclusion

Overall, the Skilled Cancer Professionals Program has had a positive impact on enhancing the capacity of individual cancer health professionals. The program has made strong progress against the short and medium term objectives, contributing essential enabling steps towards the long term change.

The majority of participants reported the acquisition of new skills and techniques and the application of new evidence into daily practice. There is evidence to suggest that participants have taken on leadership roles within their professions and influenced team practice change.

The Academic Chairs Program has targeted change at a system-wide level. Those Chairs who have been in their positions for several years are demonstrating the foundations to enable sound research outcomes for the cancer profession and improved clinical practice.

References

1. Ferlie E.B; Shortell, S.M. (2001). "Improving the quality of health care in the United Kingdom and the United States; a framework for change." The Milbank Quarterly 79: 281-315.