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Background:  Lung cancer (LC) is a complex disease requiring coordination of multiple healthcare professionals. A recently implemented LC Multidisciplinary Clinic (MDC) at Kingston Health Sciences Centre, an academic tertiary care hospital, improved timeliness of oncology assessment and treatment. This study describes patient, caregiver, and physician experiences in the MDC.Methods:  We qualitatively studied patient, caregiver, and physician experiences in a traditional siloed care model and in the MDC model. We used purposive sampling to conduct semi-structured interviews with patients and caregivers who received care in either model, and physicians who worked in both models. Thematic design was used to analyze data through open coding in Atlas-ti.Results: Six of the 72 identified patients from the traditional model, and 6 of the 40 identified patients from the MDC model, participated. Caregivers were encouraged to join patient interviews. Eight of nine physicians who provided care in both models were interviewed (2 respirologists, 2 medical oncologists, 4 radiation oncologists). Four themes emerged: communication and collaboration, efficiency, quality of care, and impact on patient outcomes. Patients in both models had positive impressions of their care. MDC patients frequently reported convenience and a positive impact of family presence at appointments. Physicians reported that the MDC improved communication and collegiality, clinic efficiency, patient outcomes and satisfaction, and consistency of information provided to patients. Physicians identified lack of clinic space as an area for improvement in the MDC. Conclusions:  This exploratory study informs our understanding of the effects of change in a multidisciplinary healthcare delivery model by directly studying those involved.

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ObjectivesWork addiction is not contingent on personality alone; it is also impacted by social contextual factors. Work addiction influences the perceived quality of care and intention to remain in healthcare sector. The current study seeks to understand the role of ethical climate as a potential organisational lever to reduce such addiction, especially among newcomers.DesignWe contacted a sample of Canadian healthcare organisations to collect quantitative data using an online questionnaire from November 2021 to February 2022. All constructs (ethical climate, work addiction, perceived quality of care, intention to quit the profession) were measured using validated psychometric scales. 860 respondents provided complete questionnaires. We analysed the data using structural equation modelling and regression analysis.ResultsWork addiction mediated the indirect relationship between ethical climate and the intention to quit the profession (β=−0.053; 95% CI (−0.083 to –0.029); p<0.001) and with quality of care (β=0.049; 95% CI (0.028, 0.077); p<0.001). For each increase of 1 SD of ethical climate, the total effects regarding the variations in the outcomes were more important at low rather than high levels of tenure for work addiction (−11%, −2%), perceived quality of care (23%, 11%) and intention to quit the profession (−30%, −23%), respectively.ConclusionEthical climate in healthcare organisations has a significant and beneficial relationship with healthcare workers’ (HCWs) work addiction behaviours. In turn, this relationship is related to greater perceived quality of care and higher intention to remain, especially for HCWs with lower tenure.