Synthesis maps as visual knowledge translation in primary care for the cancer patient’s complex lifecycles

Peter Jones pjones@ocadu.ca

Abstract



Two system maps were developed as knowledge translation products for the groundbreaking CanIMPACT study (Canadian Team to Improve Community-based Cancer Care along the Continuum), a 5-year CIHR study of primary care practices for the Canadian Cancer system. Developed over a 6 month duration of design research, the synthesis maps present the integration of clinical research from social systemic perspectives. The two maps include: 1) Clinical system map of Cancer care across Canada that illustrates the relationship between Cancer touchpoints from prevention to survivorship, and 2) Patient-as-person map, that visually narrates patient experiences and relationship in the cancer journey, co-created by Cancer survivors from the study’s Patient Advisory Committee.
Synthesis maps integrate research evidence and multiple perspectives in visual forms that both reveal systemics and narrate a visual story for knowledge translation to health care decision makers. The maps serve as translation tools to 1) help clinicians understand the complexity of the continuum of Cancer care, 2) enable stakeholders to better find and frame system interventions, 3) construct a common language and understanding across cancer care stages and practices to facilitate better primary care strategies, and 4) facilitate communication about the total life cycle of care with patients.
During the course of our interviews, analysis and map development we recognized that a patient perspective would be impossible to represent within the clinical system map, our original project remit. We co-created the patient-as-person map in successive iterations with eight members of the Patient Advisory. The synthesis map shows an interpretive, relationship-centered perspective of Cancer experience. To achieve this, we followed a completely different visual mapping approach to express the human and relational complexity of patient lifeworlds. The map represents two cancer patient personas within primary and Cancer care journeys, breast and colorectal Cancer, each illustrating a carefully defined set of conditions (age, geography, lifestyle, work, gender, family) drawn from evidence, but presented as integrated visual narratives. The patient-centered synthesis map provides a holistic narrative of the experienced Cancer care journey and an avenue to articulate critical differences between clinical and patient perspectives. The CanIMPACT study continues to define opportunities for improving care practices and to enhance primary care integration with other care modalities within the Canadian Cancer care system. The maps have been used to facilitate knowledge translation and dialogue with clinicians, researchers, health care policymakers as well as patient advocates to communicate and diagnose system issues. Finally, we note that the synthesis maps and the methodology has been recently introduced into the medical literature (Authors, Current Oncology, 2017), which facilitates building on this approach with others. 
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