Lambert Leah K, Havaei Farinaz, Beck Scott M, Ma Andy, Larmet John, Kaur Jagbir, Adhami Nassim, Le Dan, Woods Ryan
BC Cancer, Provincial Health Services Authority, Vancouver, Canada.
School of Nursing, University of British Columbia, Vancouver, Canada.
BMC Cancer. 2025 Feb 28;25(1):371. doi: 10.1186/s12885-025-13644-9.
The British Columbia (BC) government has made significant investments towards the implementation of team-based care (TBC) in its provincial comprehensive cancer control program. TBC implementation involves purposeful efforts towards: (a) establishing/expanding multidisciplinary care teams, (b) optimizing scope of practice, and (c) increasing care team consistency. Study objectives include an early-phase evaluation of (i) the association between TBC elements and team effectiveness and (ii) staff perceptions of barrier and facilitators of team effectiveness.
A series of five surveys over a 2-year period will be administered to prospectively evaluate the ongoing implementation of TBC. This study draws on data from the first of the five planned surveys, administered in May 2023. Eligible respondents included 299 program employees-spanning various roles such as physicians, nurses, and unit clerks-working within TBC at the time of survey deployment. The survey included both validated and researcher-developed questions that were either closed or open-ended, including measures of team composition, team consistency, team effectiveness, scope of practice, and demographics. Quantitative data were analyzed using descriptive and regression analysis; qualitative data were analyzed guided by interpretive description methodology.
Collected responses totaled 121, with the majority of respondents being women (76%), full-time employees (90%), and working in direct patient care (77%). Regression analyses indicated that (i) higher frequency of consistently working with the same team members and (ii) lower proportion of shifts practicing below scope are both significant predictors of higher team effectiveness ratings. Qualitative data highlighted staffing levels as a driver of under- and over-utilized scopes of practice. Furthermore, effective communication, enhanced knowledge of each team member's scope of practice, and strong interpersonal relationships were highlighted as contributing factors to effectiveness among multidisciplinary care teams.
Preliminary findings from the first of five prospective surveys highlight team consistency and role optimization as drivers of effective teamwork in the early implementation of a team-based model of cancer care. Future research should explore contextual factors that influence cancer care staff and clinicians' perceptions of effectiveness.
不列颠哥伦比亚省（BC）政府已在其省级综合癌症控制项目中对实施团队式护理（TBC）进行了大量投资。TBC的实施涉及有针对性地努力实现以下目标：（a）建立/扩大多学科护理团队，（b）优化执业范围，以及（c）提高护理团队的一致性。研究目标包括对（i）TBC要素与团队有效性之间的关联以及（ii）工作人员对团队有效性的障碍和促进因素的看法进行早期评估。
将在两年内进行一系列五次调查，以前瞻性评估TBC的持续实施情况。本研究借鉴了计划中的五次调查中的第一次调查的数据，该调查于2023年5月进行。符合条件的受访者包括299名项目员工，涵盖医生、护士和科室文员等各种角色，他们在调查开展时在TBC范围内工作。该调查包括经过验证的问题和研究人员开发的问题，这些问题既有封闭式的，也有开放式的，包括团队组成、团队一致性、团队有效性、执业范围和人口统计学等方面的测量。定量数据采用描述性和回归分析进行分析；定性数据采用解释性描述方法进行分析。
共收集到121份回复，大多数受访者为女性（76%）、全职员工（90%），且从事直接患者护理工作（77%）。回归分析表明，（i）与相同团队成员持续合作的频率较高以及（ii）低于执业范围的班次比例较低，都是团队有效性评分较高的重要预测因素。定性数据强调人员配备水平是执业范围利用不足和过度利用的驱动因素。此外，有效的沟通、对每个团队成员执业范围的深入了解以及牢固的人际关系被强调为多学科护理团队有效性的促成因素。
五次前瞻性调查中的第一次调查的初步结果突出了团队一致性和角色优化是基于团队的癌症护理模式早期实施中有效团队合作的驱动因素。未来的研究应探索影响癌症护理人员和临床医生对有效性看法的背景因素。
