Table 2 Target adoption, implementation, and maintenance outcomes and performance objectives by role

General manager (GM):

The GM decides to adopt the Co-LEC implementation program as indicated by completing a memorandum of understanding (MOU).

1. Agree to re-implement the Co-LEC

Adopter

2. Agree to expand exercise services

3. Approve updates to systems (e.g. electronic medical records, EMR), internal workflows, and policies necessary to support the exercise service

4. Approve allocation of appropriate staff to support the initiative

Oncologist:

The oncologist will tell patients about the Co-LEC and complete a referral for all eligible patients.

1. Discuss Co-LEC service with new patients

Implementer

2. Tell the patient about the chronic disease management plan payment option

3. Tick box to refer eligible patients to service

4. Check-in with patients during ongoing appointments to ask about exercise progress.

Accredited exercise physiologist (AEP):

The AEP will integrate the service utilizing standard operating protocols for other clinicians at GenesisCare.

1. Record all Co-LEC information into the electronic medical record system

2. Request ongoing appointments using electronic quick orders

Implementer

Patient services officers (PSO):

The PSO will include Co-LEC information in all new patient packets, call eligible patients to book an initial appointment at the Co-LEC, and schedule all ongoing appointments as directed by the AEP.

1. Add the Co-LEC brochure to all new patient packets

2. Call to schedule an initial appointment at the Co-LEC for all oncologist referrals

Implementer

3. Book in ongoing Co-LEC appointments based on all AEP quick orders

Billing officer:

The billing officer will match all CDMPs against patient appointments at the Co-LEC and bill accordingly.

1. Update billing protocol to include exercise claims

Implementer

2. Train staff regarding new procedures

Center leader:

The center leader will ensure all resources are available for the oncologists and PSOs.

1. Institute systems changes to EMRs and work with technology staff to make changes

Implementer

2. Ensure Co-LEC is properly resourced to perform optimally

Operations manager:

The operations manager will ensure the general manager maintains the Co-LEC as part of standard practice.

1. Monitor implementation barriers

Maintainer

2. Report key program metrics and needs to GM

3. Advocate for program changes required to sustain program