interdisciplinary cancer care team composition · tumour types: analysis of a national survey....
TRANSCRIPT
Interdisciplinary Cancer Care Team Composition and Communication Alicia Sprecher Mentors: Sarah Davis and Kathleen O’Connell The Center for Patient Partnerships
Introduction to Cancer Care
! Largely Interdisciplinary1-4
! Barriers to team success time, distance, personalities1,5,6
This Study
! Dynamics of one cancer care team
! Team defined by those providers interacting with single patient
! Define composition of cancer care team
! Identify positives and negatives in current communication practices
Methods - Subjects
! One patient selected ! Involvement with Center for Patient Partnerships ! Completed active treatment
! Patient identified other team members to be recruited ! Urologist ! Oncologist ! Oncology nurse ! Primary care provider ! Staff member from Gilda’s Club ! Patient Advocate from the Center for Patient Partnerships
! Addition individuals recruited ! 2 additional oncologists ! Patient relations specialist for the UW Hospital
Cancer Care Team Composition
Physician, nurses, MA, support staff, pharmacist
Specialized nursing roles, additional physicians (surgery, radiation),
nutritionist, psychiatry/psychology
PCP, patient, patient advocate, social support (Gilda’s Club),
patient navigator, complimentary medicine
Existing Improvements – Tumor Boards
Improved diagnosis, provider
satisfaction & adherence to standard of
care2,3.4
Improved respect between
providers5,7
Better understanding
of provider roles5,7
More immediate feedback and exchange of
ideas
Recommendations - Flagging
! Draw attention to requests for action or particular concerns
! Especially valuable when patient has appointments with non-oncology specialists
! Increases likelihood that pertinent information is transmitted
! May contribute to improved problem lists
Recommendations – Patient Navigator
• Lay person • Nurse
Individual Characteristics8
• Coordinating appointments, liaison between providers • Liaison to social support • Patient education
Activities8
• Improved time to diagnosis • Decreased patient anxiety and distress • Better completion of treatment and preparedness for
appointments
Benefits8-11
Recommendations – Improved Patient Involvement
! Patients desiring increased involvement in the cancer care team5,6
! Patient knowledge about purpose of new providers
! Expectations for appointments with new providers
! Assurance that providers are communicating
Conclusions
! Interdisciplinary tumor boards
! Patient involvement
! Flagging
! Patient navigation
! Limitations ! Only one team investigated
! Comprehensive cancer center setting
Questions?
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tumour types: analysis of a national survey. Annals of Oncology. 2011 [In Press]. 3 Palmer G Martling A, Cedermark B Holm T. Preoperative tumour staging with multidisciplinary team
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6 Ueno NT, Ito TD, Grigsby K, Black MV, Apled J. ABC conceptual model of effective multidisciplinary cancer care. Nat Rev Clin Oncol. 2010;7:544-547.
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10 Swanson J. The role of the oncology nurse navigator in distress management of adult inpatients with cancer: A retrospective study. Oncology Nursing Forum. 2010;37(1):69-76.
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