The AQUIRE Committee’s Guide to Evidence-Based Practice, Research, and Publication

August 2018 Vol 9, No 8
Elizabeth Glidden, MPH, OPN-CG
Patient Navigator, American Cancer Society/GW Cancer Center, Washington, D.C.
Pamela Goetz, BA, OPN-CG
Oncology Survivorship Navigator, Sibley Memorial Hospital, Johns Hopkins Medicine, Washington, DC
Barbara R. McHale, RN, BS, OCN, CBCN, ONN-CG
Retired Multisite Navigator
Hildegard Medicus Cancer Treatment Center, SPHP

The AQUIRE Committee's Guide to Evidence-Based Practice, Research, and Publication
Elizabeth Glidden, MPH, OPN-CG
Barbara McHale, RN, BS, OCN, CBCN, ONN-CG
Pamela Goetz, BA, OPN-CG

Impactful research can be conducted by everyone, and the AQUIRE (Assistance for Quality Improvement and Research) Committee is here to help. The mission of AQUIRE is to provide mentorship support to members of the Academy of Oncology & Patient Navigators (AONN+) in areas of quality, process improvements, metrics, and reporting. We want everyone to feel empowered and equipped to take on important projects in their work settings and believe that learning to create successful projects is an integral part of professional development.

But where do you start? Even for those of us with experience in developing and conducting research projects, this area of study may be unfamiliar.

Tips and Tricks for Success

Start with What You Know
One of the biggest challenges in research is pinpointing the starting point. In our experience, the daily challenges of navigation work leave little time to take on additional special projects. However, part of AQUIRE's goal is to demonstrate that all of us are already collecting the necessary information key to formulating a research question. What gaps in care or processes have you already noticed? What do the data you are already tracking tell you about patient needs?

Utilize the Experts Around You
You are not alone in your work. Hospitals, community clinics, and academic institutions are full of experts in clinical care, data collection, billing, data analysis, etc. Form a multidisciplinary team to help in your research. Not only will this spread out the workload, it will make your research better. Also, don't forget about the quality improvement teams that may already be in place at your facility.

Be Realistic in Scope
A thoughtful, well-designed, and well-executed project can have a large and meaningful impact on your patients, clinic, or institution. Your project must only address 1 gap in 1 patient population. This is another example in which baseline data will help inform your scope. For example, if your research focuses on patients with ovarian cancer but your hospital only treats 50 each year, it may be unrealistic to expect 45 survey responses. However, conducting a focus group with 10 of these patients would provide important feedback and result in actionable results.

Institutional Review Board? What's That?
The Institutional Review Board (IRB) is a group established to review research proposals to ensure the rights of the study participants are protected. Not all studies need IRB approval; if you are not sure, you can always submit a proposal for review or ask a research nurse, physician, or administrator for help.

Conduct the Research
Once you have completed the planning process, it's time to finally collect data! During the planning phase, make sure to address such things as:

  • How will you collect your data?
  • Which navigation metric will you use?
  • If you are using a survey, will you create your own or use an already validated tool?
  • What is your data collection timeline?
  • What other stakeholders do you need to include to help you in data collection?
  • Who is responsible for data analysis?
  • What implications do the results have for changing clinical practice?

Submitting an Abstract
Once you have completed your research, it's important to share your findings internally and externally. One of the best ways to disseminate your findings is through an abstract submission to an organization like AONN+. Abstracts are short, succinct documents highlighting the key elements of longer, more complex research. For more in-depth information about writing an abstract, we recommend listening to our committee's abstract writing webinar listed in the resources below.

Evaluation
Research projects should include follow-up. For example, are the distress screenings still being completed in the thoracic clinic 1 year after implementation? Did you discover a new problem in establishing a new administrative process that needs adjusting? It is okay to realize that a new idea or process fell short of your goal. The important part is finding a new solution to resolve the problem.

Dos and Don'ts

Tips and tricks are helpful, but translating knowledge into real use can prove difficult. For extra guidance, we spoke with Lijo Simpson, MD, coauthor of Benefits of Implementing an Automated Workflow Cancer Conference Platform, which was an award-winning abstract at last year's AONN+ annual conference.

  • Don't wait for someone else to fix the problem
    • Everyone has the responsibility to close gaps and fix problems when they are recognized. Don't be afraid to take the initiative to find a solution and propose a quality improvement project idea
  • Don't accept status quo
    • In your efforts to improve a process or program, you will most likely experience pushback from others uncomfortable with change and the unfamiliar. In these circumstances, try finding the balance between moving forward while also understanding that everyone around you will adopt change at a different rate
  • Do use technology to your advantage
    • Look for solutions that can become streamlined and more efficient through technology. Utilize the IT teams at your locations to help you understand where technology can help you
    • Technology can also be useful when collecting baseline data. Work with your cancer registrar, who has a wealth of information and statistics specific to your location
  • Do look for opportunities to collaborate
    • Collaboration is key, especially if you are also contending with colleagues slow to adopt change. Your project will be more successful if more teams benefit from the outcome
  • Do look for unintended consequences of your project
    • Even a well-designed project will have surprises at the end, so don't be afraid to look for, and share, unexpected results. For example, your team may discover that in streamlining the front desk intake process, you also increased the number of referrals to social work.

How AQUIRE and AONN+ Can Help

We want to make sure that anyone interested in conducting a research project feels supported and has the tools available to them to be successful. AQUIRE has compiled a list of AONN+ and other resources to help you and your team. There are also learning opportunities through attending an AONN+ conference, participating in an AQUIRE webinar, joining a local navigation network, or browsing through archived abstracts on the AONN+ website.

AONN+

On website: https://aonnonline.org

Under Expert Commentary tab: Evidence into Practice > Step by Step: The 4 Cs of Research
Under Conferences tab: Annual Conference > Call for Abstracts: Abstract Guidelines; under resources > Click here for Abstract criteria for acceptance; and also > How to write a research abstract
Under Education & Resources tab: > Standardized Metrics > Elaine Sein, Standardized Navigation Metrics: Where to Start; Linda Fleischer, Aligning Metrics and Individual Program Goals (videos) > Articles & Whitepapers > Danelle Johnston, Elaine Sein, Tricia Strusowski, AONN+ Announces Standardized Navigation Metrics, click on "read more" and see listing of domains with description and standardized metrics under each domain

Association of Oncology Social Work

Webinar on developing abstract and poster presentations for social workers.
http://sherwood-aosw.informz.net/z/cjUucD9taT02ODMxNDg5JnA9MSZ1PTEwNzgwND MyMDYmbGk9NDY1MTA2NjU/index.html

Purdue Online Writing Lab

American Psychological Association Style Reference Tool: https://owl.english.purdue.edu/owl/resource/560/01/

American Nurses Association

Nursing Research
www.nursingworld.org/Especiallyforyou/Nurse-Researchers
> Research Toolkit

Journal of Oncology Practice

Brief history of quality improvement http://ascopubs.org/doi/full/10.1200/JOP.2014.001436

Clinical Journal of Oncology Nursing

Author guidelines: standards, authors/contributors, title page, abstracts, key words, implications for practice, case studies, artwork, references, resources, manuscript submission, and review process https://cjon.ons.org/content/cjon-authors

Jones & Bartlett Publishing

Howlett B. Healthcare Research Methods. In: Howlett B, Rogo EJ, Shelton TG, eds. Foundations of Evidence-Based Practice. 2013
Discusses qualitative and quantitative research
Evidence hierarchy and research methods http://samples.jbpub.com/9781449652777/11637_CH02_031_054.pdf

Journal of Palliative Medicine

Wood GJ, Morrison RS. Writing abstracts and developing posters for national meetings. 2011;14(3):353-359
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114208/

Journal of Oncology Navigation & Survivorship

Author Guidelines: title, abstract, text, tables/figures, and references
www.jons-online.com/manuscript/author-guidelines

Pediatric Endocrinology Nursing Society

Andi Gordner, BS, RN; Linda Burkett, MSN, RN, CDE; PENS 2012 Research Committee. Writing a Poster Abstract: Guidelines for Success
http://pens.org/PENS%20Documents/Research%20Article%20PENS%20Reporter_Posters.pdf

PICOT Questions

P-Patient/Problem, I-Intervention, C-Comparison, O-Outcome, T-Time
Nursing Students Picot Questions http://libguides.ggc.edu/c.php?g=362349&p=2447296

Style and Grammar Resources

Proofreading Software for Grammar (free)
https://app.grammarly.com/
(Need to download app)

Walden University

Levels of Evidence Pyramid; randomized controlled trials, cohort studies, case-controlled studies, case series, case reports, systematic reviews, critically appraised topics, and critically appraised individual articles
http://academicguides.waldenu.edu/healthevidence/evidencepyramid

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Last modified: August 27, 2018

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