title: Relational coordination and healthcare management in lung cancer.
abstract: In the current socio-economic scenario characterized by a growing shortage of resources and progressive budget constraints, the need to better coordinate processes in health institutions appears as a relevant aspect to ensure the future sustainability of system. In this sense, Relational Coordination (RC) provides a valuable opportunity for the reconfiguration of clinical guidelines concerning isolated single-level considerations. In this research the RC model has been applied to explain best results in the process of diagnosing and offering clinical treatments for lung cancer. Lung cancer presents the higher rates of tumor's mortality worldwide. Through unstructured and informal interviews with clinicians at both levels (Primary/Specialist Care), a diagnosis of the situation in relation to joint management of lung cancer is provided. Solutions of continuity in terms of coordination are explained due to the observation of lack of effective knowledge transfer between the two levels. It is this disconnection which justifies the introduction of a modified model of RC for the study and implementation of transfer relations between the knowledge holders, in order to structure consolidated and cooperative evidence-based models that lead to a substantial shortening in the response times with a marked outcomes improvement. To our knowledge, the application of this model to a Public Health problem bringing together both levels of care, hasn't been made till now.
authors.affiliation: José Antonio Vinagre Romero, Clinical Management, Business Organization, Entrepreneurship, Health Administration, Business Organization, Universidad Rey Juan Carlos, Respiratory Unit at La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: José Antonio Vinagre
authors.initials: JA
authors.lastname: Romero
authors.affiliation: José Antonio Vinagre Romero, Clinical Management, Business Organization, Entrepreneurship, Health Administration, Business Organization, Universidad Rey Juan Carlos, Respiratory Unit at La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Juan Del Llano
authors.initials: Jdel L
authors.lastname: Señarís
authors.affiliation: José Antonio Vinagre Romero, Clinical Management, Business Organization, Entrepreneurship, Health Administration, Business Organization, Universidad Rey Juan Carlos, Respiratory Unit at La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Carmen De Pablos
authors.initials: Cde P
authors.lastname: Heredero
authors.affiliation: José Antonio Vinagre Romero, Clinical Management, Business Organization, Entrepreneurship, Health Administration, Business Organization, Universidad Rey Juan Carlos, Respiratory Unit at La Paz University Hospital, 28046 Madrid, Spain.
authors.forename: Mark
authors.initials: M
authors.lastname: Nuijten
keywords: Clinical pathway; Dialogic practices; Healthcare performance; High performance work systems; Lung cancer; Relational Coordination