Table 3 Occurrence of each coded text unit from interviews conducted between 2008 to 2011

Implementation Effectiveness

So far during this current grant period they’ve only put 11 patients on and they were pretty good about putting about one-third of the patients for the program overall on. So they were good for 30 or 35 [patients].

Organizational Readiness for Change*

I had the feeling that they were fairly confident, not overwhelmingly confident but fairly confident that they’d be able to do it [make the minimum requirements to become a CCOP].

Management Support

Well, we were doing the research and I don’t know if they [hospital management] still know exactly what the CCOP is. They know it’s a grant for our research program. I don’t think there’s a lot of understanding at exactly how much that the research staff does.

Resources Available

We’re having problems with the trials. We are not—and across the board, the physicians from different areas—the Rad Onc physicians are saying we just don’t have the RTOG trials that we need to be able to work with you all.

Implementation Policies & Practices

…so we'll see a patient, say we have somebody hat comes in adjuvant colon cancer, and then they potentially could be eligible for N0147. Then we’ll put the information in the chart for the physician with our card and the consent…then we’ll put the guts of the protocol, like the schema and the treatment plan, eligibility in the calendar, and then I have a—what we call pink sheet. It’s a communication sheet that we’ll write out for the physician, and we’ll tell him this is what it looks like this patient might be eligible for, and these are the tests needed, and there’s the consent.

Implementation Climate

I don’t feel the Rad Oncs are as committed to it, for whatever reason, and it may be because of the way they’re set up and the way they do their work, and it may be set up because of the way their administration is, because we’re a private group. I don’t know for whatever reason why. There's no financial incentive to do it, but I just don’t feel that they’re into it as much.

Innovation- Values Fit

I think they [physicians] all want to do research. I think they all want to get their patients the highest level of care. I think that in order to participate with the studies that that’s what they’re doing. So they’re looking for the best way to serve their patients, as well as helping with the hospital.

External Factors

It [economic downturn] has had more of an impact than I would have thought. I was probably naïve about that but patients are much more concerned about their co-pays and about what additional charges they might be facing for things that most of us would consider mundane visits like the infusion room charge when they’re here getting a free drug on a research study. Those things sometimes have been knockout punches for us.

Total text units over study period