A talented group of individuals, many of them stars in their own right, gathered in Phoenix in February to begin forming a team that could take on the toughest of problems.
This was a gathering of teams of oncologists, nurses, primary care doctors, and staff who participated in a workshop for Teams in Cancer Care Delivery, a joint-initiative between ASCO and the National Cancer Institute (NCI) to bring together researchers and clinicians involved in cancer care.
“NCI’s goal is to reduce morbidity and mortality from cancer, so figuring out how to deliver efficacious treatment is important to us,” said Stephen Taplin, MD, MPH, of NCI. “We look at how care works and how we deliver care, and one of the key pieces is how groups work together.”
Enhancing Team-Based Care
The Teams in Cancer Care Delivery initiative is an effort to bring together the world’s largest multidisciplinary cancer care society and the federal government’s principal agency for cancer research and training in order to learn about current research in team-based cancer care and explore changes that that will positively affect team-based care for patients with cancer.
Team science has been well developed in many industries but has not been systematically applied to clinical care, said Michael Kosty, MD, FACP, FASCO, of Scripps Green Cancer Center and ASCO lead for the Teams in Cancer Care Delivery project. Specifically, there is little literature applicable to the care of patients with cancer.
“We want to take team science, a discipline that has not been involved all that much in health care in general and not at all in cancer care, and see how cancer care might be improved by employing some of these team principles,” Dr. Kosty said.
The result of the meeting was a well-defined process whereby individuals functioning as teams could analyze their workflow and interactions both internally and externally, Dr. Kosty said. The workshop discussed a need for planning meetings where cancer care is delivered, so that a process can be put in place with metrics to develop pilot programs, which can improve care from a variety of perspectives—improving patient and provider satisfaction, communication, shared goals and decision making, mutual trust, and cognition.
The Teams in Cancer Care Delivery workshop helped build on earlier efforts, led by Dr. Taplin and Dr. Kosty, published in the April 2015 issue of Journal of Oncology Practice (JOP) examining ways to improve team-based care.
The article, “Reviewing Cancer Care Team Effectiveness,” provided a systematic review of literature published between 2009 and 2014 on all teams with clear membership, a comparator group, and patient-level metrics of cancer care. Meanwhile, a second article, “Teams and Teamwork During a Cancer Diagnosis: Interdependency Within and Between Teams,” illustrated how clinicians work within and between groups to deliver the first phase of cancer care.
February’s workshop built on the themes of those articles with panels on, “Addressing Barriers to Managing Communication in Multidisciplinary Cancer Teams,” “Overcoming Challenges to Effective Multi-Team Systems,” “Engaging Opportunities to Build Team Communication and Trust,” and “Implementing Goal Setting, Task Interdependence, and Behaviors of Effective Teams.”
“One of the themes was ways to improve communication within a team and within an organization,” Dr. Kosty said. “Patients often will transition from a local care provider to maybe a university setting then back to that local oncologist. Every time there is a handoff, there is potential for breakdown, inefficiency, and mistakes if information isn’t communicated.”
The draft findings from the researcher-clinician writing teams at the Teams in Cancer Care Delivery workshop will be compiled as manuscripts for a special supplement of JOP. The final publications, Dr. Taplin said, will hopefully help the Teams in Cancer Care Delivery project fulfill its goal of bringing together scientists and clinicians working on issues relevant to the effectiveness of teams involved in cancer care delivery in order to inform the research agenda for teamwork, team effectiveness, and team performance in an oncology care setting and an era of health reform.
“My hope is that this workshop will help provide some immediate relief for the people feeling the stresses of cancer care,” Dr. Taplin said. “There are principles and there are things that both patients and providers can think about and implement right now to consciously improve their care.”
– Jack Lambert