Opportunities for Improving the Transplant Assessment and Education Process in British Columbia: Patient and Health Care Provider Perspective.

Background: There are several steps patients and their health care providers must navigate to access kidney transplantation in British Columbia (BC). Objective: We explored perceptions and experiences with the pretransplant process across BC to determine where process improvements can be made to enhance access to transplantation. Design: Anonymous surveys were sent online and via post to health care providers (including nephrologists, registered nurses, and coordinators) and patients across BC. Setting: Kidney care clinics, transplant regional clinics, and provincial transplant centers in BC. Measurements: Surveys included Likert scale questions on the current pretransplant process and transplant education available in BC. The health provider survey focused on understanding the pretransplant process, knowledge, roles, and communication while the patient survey focused on patient education and experience of the pretransplant processes. Results: A total of 100 health care providers and 146 patients responded. Seventy-six percent of health care providers understood their role and responsibility in the pretransplant process, while only 47% understood others' roles in the process. Fifty-nine percent of health care respondents felt adequately supported by the provincial donor and transplant teams. Seventy-one percent of registered nurses and 92% of nephrologists understood transplant eligibility. About 68% and 77% of nurses and nephrologists, respectively, reported having enough knowledge to discuss living donation with patients. Fifty percent of patients had received transplant education, of which 60% had a good grasp of the pretransplant clinical processes. Sixty-three percent felt their respective kidney teams had provided enough advice and tools to support them in finding a living donor. Fifty percent of patients reported feeling up to date with their status in the evaluation process. Limitations: This analysis was conducted between December 2021 and June 2022 and may need to account for practice changes that occurred during the COVID-19 pandemic. Responses are from a selection of health care providers, thus acknowledging a risk of selection bias. Furthermore, we are not able to verify patients who reported receiving formal transplant education from their health care providers. Conclusions: Exploring these themes suggests communication with regional clinics and transplant centers can be improved. In addition, patient and staff education can benefit from education on kidney transplantation and the pretransplant clinical processes. Our findings provide opportunities to develop strategies to actively address modifiable barriers in a patient's kidney transplantation journey.

Contexte: En Colombie-Britannique (C.-B.), pour accéder à la transplantation, les patients et leurs prestataires de soins doivent traverser plusieurs étapes. Objectif: Nous avons exploré les perceptions et expériences en lien avec le processus de pré-transplantation dans toute la Colombie-Britannique, afin de cibler les améliorations qui pourraient y être apportées pour faciliter l'accès à la transplantation. Conception: Des sondages anonymes ont été envoyés en ligne et par la poste aux prestataires de soins de santé (notamment des néphrologues, des infirmières autorisées et des coordonnateurs) et aux patients de partout en Colombie-Britannique. Cadre de l'étude: Cliniques de soins rénaux, cliniques régionales de transplantation et centres provinciaux de transplantation en Colombie-Britannique. Mesures: Les sondages comprenaient des questions à échelles de Likert portant sur le processus actuel de pré-transplantation et l'éducation offerte sur la transplantation en Colombie-Britannique. Le sondage destiné aux prestataires de soins portait sur leur compréhension du processus de pré-transplantation, leurs connaissances, leurs rôles et la communication; le sondage destiné aux patients portait sur l'éducation reçue et leur expérience des processus de pré-transplantation. Résultats: En tout, 100 prestataires de soins et 146 patients ont répondu au sondage. Parmi les prestataires de soins, 76 % comprenaient leur rôle et leurs responsabilités dans le processus de pré-transplantation, mais 47 % seulement comprenaient le rôle des autres prestataires de soins dans le processus. Une proportion de 59 % des intervenants en santé se sentait adéquatement appuyée par les équipes provinciales de dons d'organes et de transplantation. Une grande majorité des infirmières autorisées (71 %) et des néphrologues (92 %) comprenaient les critères d'admissibilité à la transplantation. Les infirmières (68 %) et les néphrologues (77 %) estimaient avoir suffisamment de connaissances pour discuter du don vivant avec les patients. Quant aux patients, 50 % avaient reçu de l'éducation sur la transplantation et, de ceux-ci, 60 % avaient une bonne compréhension des processus cliniques de pré-transplantation. La majorité des patients (63 %) estimaient avoir reçu suffisamment de conseils et d'outils de la part de leurs équipes de soins rénaux pour les aider à trouver un donneur vivant. La moitié des patients (50 %) pensaient connaître leur statut dans le processus d'évaluation. Limites: Cette étude a été réalisée entre décembre 2021 et juin 2022 et pourrait devoir tenir compte des changements de pratiques survenus pendant la pandémie de COVID-19. Les réponses provenant d'une sélection de prestataires de soins de santé, nous reconnaissons ainsi un possible biais de sélection. Enfin, nous ne sommes pas en mesure d'évaluer les patients qui ont déclaré avoir reçu de l'éducation formelle sur la transplantation de la part de leurs prestataires de soins. Conclusion: L'exploration de ces thèmes a suggéré que la communication avec les cliniques régionales et les centres de transplantation peut être améliorée. De plus, les patients et le personnel soignant pourraient tirer profit d'éducation sur la transplantation rénale et les processus cliniques de pré-transplantation. Nos résultats offrent des occasions d'élaborer des stratégies pour s'attaquer activement aux obstacles modifiables dans le parcours de transplantation rénale d'un patient.

Social Media Use Among Physicians and Trainees: Results of a National Medical Oncology Physician Survey.

PURPOSE: Cancer management requires coordinated care from many health care providers, and its complexity requires physicians be up to date on current research. Web-based social media support physician collaboration and information sharing, but the extent to which physicians use social media for these purposes remains unknown. The complex field of oncology will benefit from increased use of online social media to enhance physician communication, education, and mentorship. To facilitate this, patterns of social media use among oncologists must be better understood. METHODS: A nine-item survey investigating physician social media use, designed using online survey software, was distributed via e-mail to 680 oncology physicians and physicians in training in Canada. Responses were analyzed using descriptive statistics. RESULTS: A total of 207 responses (30%) were received; 72% of respondents reported using social media. Social media use was highest, at 93%, in respondents age 25 to 34 years and lowest, at 39%, in those age 45 to 54 years. This demonstrates a significant gap in social media use between younger users and mid- to late-career users. The main barrier to use was lack of free time. CONCLUSION: The identified gap in social media use between age cohorts may have negative implications for communication in oncology. Despite advancements in social media and efforts to integrate social media into medical education, most oncologists and trainees use social media rarely, which, along with the age-related gap in use, may have consequences for collaboration and education in oncology. Investigations to further understand barriers to social media use should be undertaken to enhance physician collaboration and knowledge sharing through social media.

Social media in cancer care: opportunities to improve care in locally advanced breast cancer.

PURPOSE OF REVIEW: To examine the current data supporting use of social media in breast cancer clinical care. RECENT FINDINGS: Although opportunities to utilize social media to increase knowledge have been commonly seized, the opportunity to improve communication among clinicians is lagging. Locally advanced breast cancer (LABC) requires timely coordination of care among many specialists, and presents an excellent scenario for enhanced utilization of current IT strategies. SUMMARY: A systematic review was conducted to assess the use of social media to enhance breast cancer care. In addition, a Web-based search using common search engines and publicly available social media was conducted to determine the prevalence of information and networking pages aimed at patients and clinicians. Over 400 articles were retrieved; 81% focused on delivery of information or online support to patients, 17% focused on delivery of information to physicians, and 1% focused on the use of social media to improve collaboration among clinicians. Web searches retrieved millions of hits, with very few hits relating to improving collaboration among clinicians. Although there is significant potential to utilize current technologies to improve care for patients and improve connectedness among clinicians, most of the currently available technologies focus solely on the delivery of information.