Hanson, Christopher S.. The Institute of Medicine's 2001 report on palliative cancer care as an instrument of innovation in palliative oncology. Retrieved from https://doi.org/doi:10.7282/T3Q52Q0S
DescriptionThis dissertation assesses the effectiveness of the 2001 Institute of Medicine (IOM) report on palliative cancer care at inducing innovations in cancer research and practice among key organizational stakeholders in the health care system, including those concerned with cancer research and the provision of health care. The IOM report on cancer palliation was written by the National Cancer Policy Board, a diverse group consisting of prominent scientists, health care providers, third party payors, social scientists, patient advocates and others who have an interest in the development of cancer research, practice, and financing. Between 1997 and 2005 the Board published reports on cancer prevention, control, diagnosis, treatment, and palliation, until it was reorganized as the National Cancer Policy Forum.
The authors of the 2001 IOM report on cancer palliation found that patients who are dying of cancer usually face an enormous burden of physical discomfort, lost functionality, and psychological stress, as well as a strong possibility of economic hardship. The authors made ten recommendations, summarized into five program areas that address the need to improve research, practice, and reimbursement for palliative, supportive, and end-of-life care, and to improve the quality of educational materials oriented toward the patients with advanced cancer and their loved ones. Taken together these recommendations represent a complex organizational innovation, which the Board sought to induce by publishing the report.
This dissertation presents a case study of induced diffusion of innovation, by policy entrepreneurship within an epistemic community. The analysis includes review of documents, content analysis of relevant parts of the National Cancer Institute research program from 1998--2005 and professional journals from 1994--2004, and semi-structured interviews with key informants. The findings show that although the report's recommendations were sound its impact was limited by entrenched cultures at NCI and among professional groups.