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Christopher Lindsell

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    P2.11 - Screening and Early Detection (ID 178)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.11-33 - Organizational Readiness for Implementation of Lung Cancer Screening in a Veterans Affairs Healthcare System  (ID 709)

      10:15 - 18:15  |  Author(s): Christopher Lindsell

      • Abstract


      Implementation of high quality lung cancer screening is complex and requires close coordination between radiology and primary care teams. Organizational readiness for change (ORC) is an important factor in successful implementation of complex healthcare programs such as lung cancer screening. Using the Consolidated Framework for Implementation Research (CFIR), we tested the hypothesis that ORC would differ between radiology and primary care prior to deployment of a centralized lung cancer screening program.


      We conducted a cross-sectional observational study. We invited all radiology and primary care providers (hospital and community-based) and affiliated staff at a single large VA Healthcare System in the US by email to participate in a web-based survey. We measured demographic information and adapted 9 validated items on ORC (domains of change commitment and change efficacy) and 10 items on change valence (value of a planned organizational change) using a 7-point Likert-type scale. Respondents’ ORC and change valence scores were calculated by averaging individual item responses for each scale. The primary outcome, ORC, was evaluated as a continuous variable with higher scores representing more readiness. We compared mean ORC scores between radiology and primary care using independent 2-sample t-tests.


      The overall response rate was 54% (76/128 [59.4%] radiology, 206/398 [51.8%] primary care). After 12 respondents were excluded for incomplete data (5 from radiology and 7 from primary care), the analytical sample was 270 respondents. Respondents were on average 47 years old [SD 11.24], 72% female, and 17% self-identified as having a leadership role. Individuals affiliated with radiology reported higher ORC than those affiliated with primary care (5.50 [SD 1.42] versus 5.07 [SD 1.22], p=0.03). Individuals self-identifying as having leadership roles in implementation of lung cancer screening reported higher ORC than those without leadership roles (5.56 [SD 1.38] vs 5.11 [SD 1.28], p=0.05). Those with leadership roles reported higher change valence than those without (5.91 [SD 1.20] vs. 5.36 [SD 1.88], p=0.006). We found no difference in reported change valence between radiology and primary care.


      Radiology providers and staff have higher perceived ORC to implement a centralized lung cancer screening program compared to primary care. Providers and staff with implementation leadership roles reported higher ORC than those without leadership roles. Understanding these differences in readiness will inform future work as we focus on strategies to engage primary care providers and staff during implementation of lung cancer screening. We will deploy these strategies at Veterans Health Administration facilities across the US with the support of the VA-Partnership to increase Access to Lung cancer Screening (VA-PALS) and the VA Office of Rural Health.