title: Assessing the Development of Multidisciplinary Care: Experience of the National Cancer Institute Community Cancer Centers Program.
abstract: The National Cancer Institute Community Cancer Centers Program (NCCCP) began in 2007 with a goal of expanding cancer research and delivering quality care in communities. The NCCCP Quality of Care (QoC) Subcommittee was charged with developing and improving the quality of multidisciplinary care. An assessment tool with nine key elements relevant to MDC structure and operations was developed.
  
  
  
  Fourteen NCCCP sites reported multidisciplinary care assessments for lung, breast, and colorectal cancer in June 2010, June 2011, and June 2012 using an online reporting tool. Each site evaluated their level of maturity (level 1 = no multidisciplinary care, level 5 = highly integrated multidisciplinary care) in nine elements integral to multidisciplinary care. Thematic analysis of open-ended qualitative responses was also conducted.
  
  
  
  The proportion of sites that reported level 3 or greater on the assessment tool was tabulated at each time point. For all tumor types, sites that reached this level increased in six elements: case planning, clinical trials, integration of care coordination, physician engagement, quality improvement, and treatment team integration. Factors that enabled improvement included increasing organizational support, ensuring appropriate physician participation, increasing patient navigation, increasing participation in national quality initiatives, targeting genetics referrals, engaging primary care providers, and integrating clinical trial staff.
  
  
  
  Maturation of multidisciplinary care reflected focused work of the NCCCP QoC Subcommittee. Working group efforts in patient navigation, genetics, and physician conditions of participation were evident in improved multidisciplinary care performance for three common malignancies. This work provides a blueprint for health systems that wish to incorporate prospective multidisciplinary care into their cancer programs.
authors.affiliation: Lehigh Valley Health Network, Allentown, PA; National Cancer Institute, Rockville; Frederick National Laboratory for Cancer Research, Frederick, MD; and The Queen's Medical Center, Honolulu, HI Eliot_L.Friedman@lvhn.org.
authors.forename: Eliot L
authors.initials: EL
authors.lastname: Friedman
authors.affiliation: Lehigh Valley Health Network, Allentown, PA; National Cancer Institute, Rockville; Frederick National Laboratory for Cancer Research, Frederick, MD; and The Queen's Medical Center, Honolulu, HI.
authors.forename: Neetu
authors.initials: N
authors.lastname: Chawla
authors.affiliation: Lehigh Valley Health Network, Allentown, PA; National Cancer Institute, Rockville; Frederick National Laboratory for Cancer Research, Frederick, MD; and The Queen's Medical Center, Honolulu, HI.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Morris
authors.affiliation: Lehigh Valley Health Network, Allentown, PA; National Cancer Institute, Rockville; Frederick National Laboratory for Cancer Research, Frederick, MD; and The Queen's Medical Center, Honolulu, HI.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Castro
authors.affiliation: Lehigh Valley Health Network, Allentown, PA; National Cancer Institute, Rockville; Frederick National Laboratory for Cancer Research, Frederick, MD; and The Queen's Medical Center, Honolulu, HI.
authors.forename: Angela C
authors.initials: AC
authors.lastname: Carrigan
authors.affiliation: Lehigh Valley Health Network, Allentown, PA; National Cancer Institute, Rockville; Frederick National Laboratory for Cancer Research, Frederick, MD; and The Queen's Medical Center, Honolulu, HI.
authors.forename: Irene Prabhu
authors.initials: IP
authors.lastname: Das
authors.affiliation: Lehigh Valley Health Network, Allentown, PA; National Cancer Institute, Rockville; Frederick National Laboratory for Cancer Research, Frederick, MD; and The Queen's Medical Center, Honolulu, HI.
authors.forename: Steven B
authors.initials: SB
authors.lastname: Clauser
mesh_terms: D001943:Breast Neoplasms / Q000628:therapy*; D002173:Cancer Care Facilities; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000628:therapy*; D003153:Community Health Services / Q000458:organization & administration / Q000592:standards; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D054547:National Cancer Institute (U.S.); D010348:Patient Care Team; D011787:Quality of Health Care; D014481:United States