Implementation and Management of Cancer Clinical Quality Registries in Australia: A Qualitative Study

BACKGROUND: In Australia, clinical quality registries (CQRs) for cancer care are becoming increasingly common, requiring integration across multiple sectors of the health system. This study sought to identify the means to successful implementation of CQRs in Australia by identifying barriers and facilitators of implementation and sustainability, and drivers of acceptability and feasibility. METHODS: Online semi-structured interviews were conducted between May and June 2023 with directors, program leads, data managers, clinical champions, and other staff involved in implementation or management of CQRs across Australia. Barriers to and facilitators of implementing and delivering CQRs were mapped to themes of the Consolidated Framework for Implementation Research (CFIR) V.2.0. RESULTS: Twenty stakeholders were interviewed. Participants identified a wide range of feasibility and implementation challenges for CQRs, with some questioning the ability of a CQR to facilitate clinical change. Participants strongly advocated for streamlined ethics and governance processes, appropriate technology infrastructure, sustainable funding, and workforce allocation. Stakeholders identified that the ongoing success of a CQR is influenced by lack of funding, low data quality, poor stakeholder motivation, and lack of training. Practical strategies to address challenges included developing a community of practice, clear training and guidelines, instating clinical champions, and appropriate pre-planning. CONCLUSION: Strong guidance to better support organizational oversight, training, management, and CQR operations will further strengthen and support successful future implementation. Practical strategies to address implementation challenges and to provide ongoing support for CQRs included developing a community of practice, clear training and guidelines, instating clinical champions, and appropriate pre-planning.