Understanding the Complexity, Underlying Processes, and Influencing Factors for Optimal Multidisciplinary Teamwork in Hospital-Based Cancer Teams

Abstract

Background Multidisciplinary teamwork has become the standard in care for oncological patients and their treatment trajectory when comprehensive, holistic, and high-quality cancer care is needed. Working together from a variety of perspectives is difficult to achieve and has well-known pitfalls, such as miscommunication and poor coordination. Objective To describe and synthesize the factors influencing and the processes underlying optimal multidisciplinary teamwork. Methods An integrative review was conducted, guided by the framework of Whittemore and Knafl. The systematic search for literature published since 2010 in 3 databases (PubMed, Web of Science, and Scopus) yielded 49 articles. Results Eighty-eight percent of the included studies focus on multidisciplinary team meetings, rather than on the wider notion of multidisciplinary teamwork. We identified influencing factors on the basis of structural features of the team, hospital, and health system, as well as process features of multidisciplinary teamwork in multidisciplinary team meetings. Conclusion To improve multidisciplinary teamwork, the focus needs to be on the process of collaboration throughout the cancer care trajectory of the patient. A more integrated, interdisciplinary approach should be aimed for to recognize the role and contribution of all disciplines involved. Implications A cultural change is needed toward interdisciplinary practice in hospitals to reach partnership between all involved professionals as part of a participatory, collaborative, and coordinated approach.

Team functioning across different tumour types: Insights from a Swiss cancer center using qualitative and quantitative methods

“…Overall, we found a coherent pattern, suggesting that policies and guidelines to support MDT functioning sufficiently address the needs and ways of working of all types of MDTMs in Swiss cancer centres. This study is largely replicating a pattern found in MDTMs globally 8 . From a research perspective the tools that this study applied, can be used to carry out comparative analyses between cancer centres in Switzerland and beyond 41 .…”

“…In the most recent systematic review of team working in cancer teams that we are aware of, Horlait et al 8 reviewed 49 studies carried out across 12 countries. The review offers a framework for considering the evidence base on team working in MDTMs – which includes structural characteristics (of MDTMs, hospitals and healthcare systems), leadership, participation and involvement, and organisational culture.…”

“…This study is largely replicating a pattern found in MDTMs globally. 8 From a research perspective the tools that this study applied, can be used to carry out comparative analyses between cancer centres in Switzerland and beyond. 41 From a practice perspective, the tools used to characterise MDTMs may also be useful for cancer teams to analyse their own work patterns and identify opportunities for improvement – for example, through the formal appointment of a skilled MDTM chairperson to facilitate the case reviews.…”

“… 7 Collaboration and teamwork are increasingly recognised as central aspects of a successful cancer patient care. 8 In the wider healthcare literature, the argument has been consistently made over the past decade that team functioning can be improved through analysis of a team, identification of any deficits and implementation of interventions. 9 , 10 How to specifically support the way cancer MDTMs function, however, remains less well understood.…”

“…Cancer treatment processes managed by teams are subject to several internal and external influences 7 . Collaboration and teamwork are increasingly recognised as central aspects of a successful cancer patient care 8 . In the wider healthcare literature, the argument has been consistently made over the past decade that team functioning can be improved through analysis of a team, identification of any deficits and implementation of interventions 9,10 .…”