Synthesis Maps from CanIMPACT | Mapping the Clinical Cancer System

Peter Jones Design for Care, Service Design, Systemic Design

The CanIMPACT project (Canadian Team to Improve Community-Based Cancer Care Along the Continuum) is a multidisciplinary pan-Canadian program studying how to improve cancer care to patients in the primary care setting. Funded by the Canadian Institutes of Health Research for 5 years (2013–2018, Grant no. 128272) the project was led by Dr. Eva Grunfeld, Director of Research at U Toronto’s Dept of Family and Community Medicine.  For the CanIMPACT synthesis map project, our sLab team (Jones, Smriti Shakdher, Prateeksha Singh).  Two synthesis maps were prepared to reflect the discovered insights from the multi-year investigation, a clinical system map and a patient-centred map informed by the CanIMPACT Patient Advisory Council. The resulting maps were published (a first for a system map method) in Current Oncology and presented at the first Canadian Partnership Against Cancer (CPAC) conference, and MedicineX 2017.

Jones, P.H., Shakdher, S. & Singh, P. (2017). Synthesis maps: Visual knowledge translation for the CanIMPACT clinical system and patient cancer journeys. Current Oncology, 24 (2), 129-134.

Synthesis mapping produces high-quality representations of insights drawn from research evidence, It presents visual models of systemic patterns discovered through multidisciplinary observations, and it communicates to stakeholders and interested observers the processes, interventions and possible strategies and policy interventions in a complex system.

CanImpact Synthesis Map: Canadian Clinical System of Primary Care in the Cancer Continuum

CanImpact Synthesis Map: Patient Experience of Primary Care in the Cancer Continuum
A Relationship-Centred View of Breast and Colorectal Cancer Survivorship

(PDF copies of both maps are available by selecting the image, (c) 2016 Strategic Innovation Lab.)

Studies from the CanIMPACT project have been published in the same issue as a special edition guest edited by Dr. Grunfeld. The summative workshop at which the maps were presented, with conclusions and recommendations, is found online at NLM and Current Oncology:

Discussion of the “two solitudes” or disconnected practices of primary care and oncology are described in Eva’s second article in the same issue:

The Current Oncology article presents a simplified summary of the design action research process we used in developing the synthesis maps in the CanIMPACT project. These steps would be representative of an evidence-driven approach, and while not all synthesis maps are models of system knowledge from evidence, it is a well-suited technique for a range of complex knowledge problems in healthcare, medicine, community and mental health, education, social policy, and other institutional and policy sectors.

  • Domain and Literature Review A scoping review of the CanIMPACT study and its references was conducted. Continuous searches informed emergent questions for representing mapping decisions.
  • Expert Interviews and Content Analysis, with Visual Notetaking. The CanIMPACT qualitative study, the Casebook survey of cancer initiatives, and administrative data substudy reports were analyzed, guided by interviews with study area leads.
  • Knowledge Synthesis to Design Maps in Stages In collaborative sessions, maps were hand-sketched to represent salient findings drawn from content analyses. Peer Critique of Electronic and Print Maps Structured critiques of the maps were held with the CanIMPACT and PAC experts at key stages of map development.
  • Iterative Map Design The clinical map was developed first, in stages that adhered to the method. The necessity for a patient-centred map was discovered during the peer critique step.