Browsing by Author "Martinez-Gutierrez, Javiera"

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    Adoption, acceptance, and use of a decision support tool to promote timely investigations for cancer in primary care
    (2024) Chima, Sophie; Hunter, Barbara; Martinez-Gutierrez, Javiera; Lumsden, Natalie; Nelson, Craig; Manski-Nankervis, Jo-Anne; Emery, Jon
    Background The complexities of diagnosing cancer in general practice has driven the development of quality improvement (QI) interventions, including clinical decision support (CDS) and auditing tools. Future Health Today (FHT) is a novel QI tool, consisting of CDS at the point-of-care, practice population-level auditing, recall, and the monitoring of QI activities.Objectives Explore the acceptability and usability of the FHT cancer module, which flags patients with abnormal test results that may be indicative of undiagnosed cancer.Methods Interviews were conducted with general practitioners (GPs) and general practice nurses (GPNs), from practices participating in a randomized trial evaluating the appropriate follow-up of patients. Clinical Performance Feedback Intervention Theory (CP-FIT) was used to analyse and interpret the data.Results The majority of practices reported not using the auditing and QI components of the tool, only the CDS which was delivered at the point-of-care. The tool was used primarily by GPs; GPNs did not perceive the clinical recommendations to be within their role. For the CDS, facilitators for use included a good workflow fit, ease of use, low time cost, importance, and perceived knowledge gain. Barriers for use of the CDS included accuracy, competing priorities, and the patient population.Conclusions The CDS aligned with the clinical workflow of GPs, was considered non-disruptive to the consultation and easy to implement into usual care. By applying the CP-FIT theory, we were able to demonstrate the key drivers for GPs using the tool, and what limited the use by GPNs.
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    Optimization of a Quality Improvement Tool for Cancer Diagnosis in Primary Care: Qualitative Study
    (2022) Chima, Sophie; Martinez-Gutierrez, Javiera; Hunter, Barbara; Manski-Nankervis, Jo-Anne; Emery, Jon
    Background: The most common route to a diagnosis of cancer is through primary care. Delays in diagnosing cancer occur when an opportunity to make a timely diagnosis is missed and is evidenced by patients visiting the general practitioner (GP) on multiple occasions before referral to a specialist. Tools that minimize prolonged diagnostic intervals and reduce missed opportunities to investigate patients for cancer are therefore a priority.