Teams and Teamwork During a Cancer Diagnosis: Interdependency Within and Between Teams

Taplin, Stephen H.; Weaver, Sallie J.; Chollette, Veronica; Marks, Lawrence B.; Jacobs, Andrew; Schiff, Gordon D.; Stricker, Carrie Tompkins; Bruinooge, Suanna S.; Salas, Eduardo

doi:10.1200/jop.2014.003376

Cited by 78 publications

(82 citation statements)

References 30 publications

(9 reference statements)

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“…Whether they operate as a team or as team of teams is an important question that is not fully understood. 26 The enduring and universal strength of primary care is a core commitment to generalism. This is supported by a continuous longitudinal relationship with patients, and the PCP's clinical expertise with the often undiff erentiated and ill-defi ned nature of the problems presented.…”

Section: What Is Primary Health Care and How Is It Evolving?mentioning

confidence: 99%

The expanding role of primary care in cancer control

Rubin

Berendsen

Crawford

et al. 2015

The Lancet Oncology

422

424

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The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise-from epidemiologists, psychologists, policy makers, and cancer specialists-has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to eff ect change are outlined. The strengths of primary care-its continuous, coordinated, and comprehensive care for individuals and families-are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.

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Section: What Is Primary Health Care and How Is It Evolving?mentioning

confidence: 99%

The expanding role of primary care in cancer control

Rubin

Berendsen

Crawford

et al. 2015

The Lancet Oncology

422

424

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“…Building on previous work by Taplin et al 22 and Trosman et al, 23 this article explores barriers to optimal care during breast cancer care initiation and how they could be addressed by teamwork and patient engagement, highlighting the potential role of radiology in the optimized process. We analyze how an innovative 4R Approach - Right Information and Right Care for the Right Patient at the Right Time © - for facilitating teamwork in cancer care, introduced by Trosman et al, may be applied to breast cancer care initiation and a value-added role for radiology.…”

Section: Introductionmentioning

confidence: 96%

“…22 Similarly, Trosman and colleagues focused on care breakdowns and opportunities for teamwork during breast cancer treatment. 23 However, to our knowledge, the care initiation phase – from diagnosis to start of treatment – remains unexplored in this context.…”

Section: Introductionmentioning

confidence: 99%

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Radiology as the Point of Cancer Patient and Care Team Engagement: Applying the 4R Model at a Patient’s Breast Cancer Care Initiation

Weldon

Friedewald

Kulkarni

et al. 2016

Journal of the American College of Radiology

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Radiologists aspire to improve patient experience and engagement, as part of the Triple Aim of health reform. Patient engagement requires active partnerships among health providers and the patient, and rigorous teamwork provides a mechanism for this. Patient and care team engagement are crucial at the time of cancer diagnosis and care initiation, but are complicated by the necessity to orchestrate many interdependent consultations and care events in a short time. Radiology often serves as the patient entry point into the cancer care system, especially in breast cancer. It is uniquely positioned to play the value-adding role of facilitating patient and team engagement during cancer care initiation. The 4R approach previously proposed for optimizing teamwork and care delivery during cancer treatment (Trosman, JOP 2016), could be applied at the time of diagnosis. The 4R approach considers care for every cancer patient as a project, using Project Management to plan and manage care interdependencies, assign clear responsibilities and designate a Quarterback function. We propose that radiology assume the Quarterback function during breast cancer care initiation, developing Care Initiation Sequence, as a project care plan for newly diagnosed patients, and engaging the patient and her care team in timely, coordinated activities. After initial consultations and treatment plan development, the Quarterback function is transitioned to surgery or medical oncology. This model provides radiologists with opportunities for value-added services and solidifying radiology’s relevance in the evolving healthcare environment. To implement 4R at cancer care initiation, it will be necessary to: change the radiology practice model to incorporate patient interaction and teamwork; develop the 4R content and local adaption approaches; and enrich radiology training with relevant clinical knowledge, patient interaction competence and teamwork skillset.

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“…For example, Weldon et al acknowledges that radiology is often the entry point for patients into the cancer care system [4] and is uniquely positioned to facilitate care initiation. Taplin et al illustrated the interdependency inherent in effective teams-based care by examining the care coordination between primary care, radiology and surgery to deliver care to a woman undergoing screening mammography and subsequent diagnosis of breast cancer [5]. Thus, care coordination has emerged as a key issue in effective patient care, with radiology and primary care taking active team roles.…”

Section: Introductionmentioning

confidence: 99%

Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners

Carlos

Sicks

Chang

et al. 2017

Journal of the American College of Radiology

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Purpose Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties such as primary care, radiology, and oncology. From the program’s inception, NCI Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational and social factors, including care transitions that determine patient outcomes. We aim to describe the capacity of NCORPs to conduct multidisciplinary CCDR that includes radiology and primary care practices. Methods The NCORP contains 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Results 87% of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. 79% had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice and ownership by large regional or multi-state health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly different between the community vs minority/underserved community sites. Conclusion Research relationships exist between the majority of community oncology sites and affiliated radiology practices. Research relationships with affiliated primary care practices lagged. NCORP as a whole has the opportunity to encourage continued and expanded engagement where relationships exist. Where no relationship exists, the NCORP can encourage recruitment, particularly of primary care practices as partners.

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Teams and Teamwork During a Cancer Diagnosis: Interdependency Within and Between Teams

Cited by 78 publications

References 30 publications

The expanding role of primary care in cancer control

The expanding role of primary care in cancer control

Radiology as the Point of Cancer Patient and Care Team Engagement: Applying the 4R Model at a Patient’s Breast Cancer Care Initiation

Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners

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