Registration of cancer pathways, why is it so hard

Student thesis: Master programme thesis

  • Else Glenthøj Sanogo
  • Susanne Grøndahl
3 year, Master of Health Informatics (Continuing education) (Continuing Education Programme (Master))
In recent years, there has been a focus on improving the treatment of cancer in Denmark. This has happened in a number of ways, including the implementation of cancer pathways. The monitoring of the cancer pathways is based on the National Patient Registry. The aim of this is to provide statistical foundation for quality control and development, as well as for political, administrative, and clinical decision making in the area of cancer. However, the entries often contain incorrect or incomplete data which compromises the aim. This project studies which organizational factors are pertinent to correct registration of cancer pathways. The science theory base of the project is the phenomenological hermeneutics, a transcendental philosophical epistemology and the hermeneutical circle as the ontology. The study was carried out in the Region Syddanmark, at the hospital Sydvestjysk Sygehus (SVS) and its surgical department through interviews with staff at the regional, hospital and department level. Also, an observation study in a controlled environment was conducted to look specifically at the registration task. The Leavitt-Ry model (2005) combined with the eight-stage process in Leading Change by J. Kotter (2007), and the role of information technology inspired by Thorsvik and Jacobsen (2002) was chosen as a theoretical background for the study and the analysis of the findings. Some of the pertinent factors for a correct registration of cancer pathways found in this study are: diagnoses of referral from the general practitioners are frequently incomplete or incorrect, data for the registration is gathered on paper before the actual registration by a secretary, and the patient administrative system in use at SVS is not integrated in an electronic health record, and does not offer dropdown choices or data validation, information technology is underutilized for communication and information other than through the traditional hierarchy, the head of the department is aware of the importance of maintaining motivation for the monitoring of the cancer pathways among his staff, and that vision, values, and goals are being communicated well throughout the department. In conclusion these findings lead to show an organization, that has focus on visions, values and goals, motivation, technology and the physical environment, which all are pertinent factors for a correct registration of cancer pathways. The study also shows an organization, in which the traditional hospital organization culture is an obstacle for developping a more rational communication and information structure. In the method discussion, we examine, how the results from this study can be generalized to the rest of the country. Lastly, a number of recommendations are given as to how a more correct registration of cancer pathways can be achieved.
Publication date27 May 2010
Number of pages164
Publishing institutionAalborg Universitet
ID: 31868804