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J Oncol Pract. 2015 May;11(3):239-46. doi: 10.1200/JOP.2014.003350. Epub 2015 Apr 14.

Reviewing cancer care team effectiveness.

Author information

1
National Cancer Institute, Bethesda; Johns Hopkins University School of Medicine, Armstrong Institute for Patient Safety and Quality, Baltimore; Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, MD; University of Central Florida, Orlando, FL; American Society of Clinical Oncology, Alexandria, VA; and Scripps Clinic, La Jolla, Ca taplins@mail.nih.gov.
2
National Cancer Institute, Bethesda; Johns Hopkins University School of Medicine, Armstrong Institute for Patient Safety and Quality, Baltimore; Leidos Biomedical Research, Frederick National Laboratory for Cancer Research, Frederick, MD; University of Central Florida, Orlando, FL; American Society of Clinical Oncology, Alexandria, VA; and Scripps Clinic, La Jolla, Ca.

Abstract

PURPOSE:

The management of cancer varies across its type, stage, and natural history. This necessitates involvement of a variety of individuals and groups across a number of provider types. Evidence from other fields suggests that a team-based approach helps organize and optimize tasks that involve individuals and groups, but team effectiveness has not been fully evaluated in oncology-related care.

METHODS:

We undertook a systematic review of literature published between 2009 and 2014 to identify studies of all teams with clear membership, a comparator group, and patient-level metrics of cancer care. When those teams included two or more people with specialty training relevant to the care of patients with cancer, we called them multidisciplinary care teams (MDTs). After reviews and exclusions, 16 studies were thoroughly evaluated: two addressing screening and diagnosis, 11 addressing treatment, two addressing palliative care, and one addressing end-of-life care. The studies included a variety of end points (eg, adherence to quality indicators, patient satisfaction with care, mortality).

RESULTS:

Teams for screening and its follow-up improved screening use and reduced time to follow-up colonoscopy after an abnormal screen. Discussion of cases within MDTs improved the planning of therapy, adherence to recommended preoperative assessment, pain control, and adherence to medications. We did not see convincing evidence that MDTs affect patient survival or cost of care, or studies of how or which MDT processes and structures were associated with success.

CONCLUSION:

Further research should focus on the association between team processes and structures, efficiency in delivery of care, and mortality.

PMID:
25873056
PMCID:
PMC4438110
DOI:
10.1200/JOP.2014.003350
[Indexed for MEDLINE]
Free PMC Article

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