The Anatomy and Physiology of Teaming in Cancer Care Delivery: A Conceptual Framework.
The Anatomy and Physiology of Teaming in Cancer Care Delivery: A Conceptual Framework.
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癌症护理中团队合作的解剖学和生理学：概念框架。
DOI：
10.1093/jnci/djaa166
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Weaver,SallieJ
中科院分区：
文献类型：
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作者：
Verhoeven,DanaC;Chollette,Veronica;Lazzara,ElizabethH;Shuffler,MarissaL;Osarogiagbon,RaymondU;Weaver,SallieJ
随着治疗选择的扩大、多模式治疗方案的实施以及伴有合并症的老龄化人口加剧了对多学科癌症护理的需求，癌症患者的护理协调挑战继续增长。有效的团队合作是协调癌症护理提供的关键但未得到充分研究的基石。例如，全面的肺癌护理涉及临床“团队”-或临床多团队系统（MTS）-协调跨专业，提供者和设置的决策和护理。这些团队内部和之间的团队合作过程为协调护理奠定了基础。虽然需要作为一个团队工作，并协调跨学科，组织和地理界限的增加，证据识别和改善的团队合作过程的基础护理协调和提供之间的多个团队仍然稀少。这篇评论将MTS结构特征和团队协作过程合成为一个概念框架，称为癌症MTS框架，以推进未来的癌症护理提供研究，解决护理协调中的证据差距。所包括的结构是从已发表的框架、2016年美国国家癌症研究所-美国临床肿瘤学会癌症护理小组研讨会的讨论和专家意见中确定的。肺癌的一个案例为框架的改进提供了实际的基础。癌症MTS框架确定团队结构变量和团队合作过程影响癌症护理服务，相关的结果，以及假设影响多个临床团队内部和之间的协调的背景变量。我们讨论了如何使用该框架来确定医疗服务研究的差距，开发假设驱动的研究检查临床团队的运作，并支持概念的一致性研究团队合作和护理协调及其对癌症的影响结果。
Care coordination challenges for patients with cancer continue to grow as expanding treatment options, multimodality treatment regimens, and an aging population with comorbid conditions intensify demands for multidisciplinary cancer care. Effective teamwork is a critical yet understudied cornerstone of coordinated cancer care delivery. For example, comprehensive lung cancer care involves a clinical “team of teams”—or clinical multiteam system (MTS)—coordinating decisions and care across specialties, providers, and settings. The teamwork processes within and between these teams lay the foundation for coordinated care. Although the need to work as a team and coordinate across disciplinary, organizational, and geographic boundaries increases, evidence identifying and improving the teamwork processes underlying care coordination and delivery among the multiple teams involved remains sparse. This commentary synthesizes MTS structure characteristics and teamwork processes into a conceptual framework called the cancer MTS framework to advance future cancer care delivery research addressing evidence gaps in care coordination. Included constructs were identified from published frameworks, discussions at the 2016 National Cancer Institute-American Society of Clinical Oncology Teams in Cancer Care Workshop, and expert input. A case example in lung cancer provided practical grounding for framework refinement. The cancer MTS framework identifies team structure variables and teamwork processes affecting cancer care delivery, related outcomes, and contextual variables hypothesized to influence coordination within and between the multiple clinical teams involved. We discuss how the framework might be used to identify care delivery research gaps, develop hypothesis-driven research examining clinical team functioning, and support conceptual coherence across studies examining teamwork and care coordination and their impact on cancer outcomes.