Osarogiagbon Raymond U, Rodriguez Hector P, Hicks Danielle, Signore Raymond S, Roark Kristi, Kedia Satish K, Ward Kenneth D, Lathan Christopher, Santarella Scott, Gould Michael K, Krasna Mark J
Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center; School of Public Health, University of Memphis, Memphis, TN; School of Public Health, University of California, Berkeley, Berkeley; Bonnie J. Addario Lung Cancer Foundation, San Carlos; Kaiser Permanente Southern California, Pasadena, CA; Dana-Farber Cancer Institute, Boston, MA; and Meridian Cancer Care and Rutgers Medical School, Neptune, NJ.
J Oncol Pract. 2016 Nov;12(11):983-991. doi: 10.1200/JOP.2016.013813. Epub 2016 Sep 30.
The complexity of lung cancer care mandates interaction between clinicians with different skill sets and practice cultures in the routine delivery of care. Using team science principles and a case-based approach, we exemplify the need for the development of real care teams for patients with lung cancer to foster coordination among the multiple specialists and staff engaged in routine care delivery. Achieving coordinated lung cancer care is a high-priority public health challenge because of the volume of patients, lethality of disease, and well-described disparities in quality and outcomes of care. Coordinating mechanisms need to be cultivated among different types of specialist physicians and care teams, with differing technical expertise and practice cultures, who have traditionally functioned more as coactively working groups than as real teams. Coordinating mechanisms, including shared mental models, high-quality communication, mutual trust, and mutual performance monitoring, highlight the challenge of achieving well-coordinated care and illustrate how team science principles can be used to improve quality and outcomes of lung cancer care. To develop the evidence base to support coordinated lung cancer care, research comparing the effectiveness of a diverse range of multidisciplinary care team approaches and interorganizational coordinating mechanisms should be promoted.
肺癌护理的复杂性要求具备不同技能组合和执业文化的临床医生在日常护理工作中相互协作。运用团队科学原则和基于案例的方法，我们举例说明了为肺癌患者建立真正的护理团队以促进参与日常护理工作的多名专科医生和工作人员之间协调的必要性。鉴于患者数量众多、疾病致死率高以及护理质量和结果方面存在的差异已得到充分描述，实现肺癌护理的协调是一项高度优先的公共卫生挑战。需要在不同类型的专科医生和护理团队之间建立协调机制，这些团队具有不同的技术专长和执业文化，传统上他们更多地是作为协同工作小组而非真正的团队开展工作。协调机制，包括共享心智模式、高质量沟通、相互信任和相互绩效监测，凸显了实现良好协调护理的挑战，并说明了如何运用团队科学原则来提高肺癌护理的质量和结果。为了建立支持肺癌协调护理的证据基础，应推动比较各种多学科护理团队方法和组织间协调机制有效性的研究。
