title: 'One-stop shop': lung cancer patients' and caregivers' perceptions of multidisciplinary care in a community healthcare setting.
abstract: BACKGROUND
  Multidisciplinary care is rarely practiced in community healthcare settings where the majority of patients receive lung cancer care in the US. We sought direct input from patients and their informal caregivers on their experience of lung cancer care delivery.
  
  
  METHODS
  We conducted focus groups of patient and caregiver dyads. Patients had received care for lung cancer in or out of a multidisciplinary thoracic oncology clinic coordinated by a nurse navigator. Focus groups were audiotaped, transcribed, and analyzed using Creswell's 7-step process. Recurring overlapping themes were developed using constant comparative methods within the Grounded Theory framework.
  
  
  RESULTS
  A total of 46 participants were interviewed in focus groups of 5 patient-caregiver dyads. Overlapping themes were a perception that multidisciplinary care improved physician collaboration, patient-physician communication, and patient convenience, while reducing redundancy in testing. Improved coordination decreased confusion, stress, and anxiety. Negative experience of serial care included poor communication among physicians, insensitive communication about illness, delays in diagnosis and treatment, misdiagnosis, and mistreatment. Physician-to-physician communication and patient education were suggested areas for improvement in the multidisciplinary model.
  
  
  CONCLUSIONS
  Multidisciplinary care was perceived as more patient-centered, effective, safe, and efficient than standard serial care. It was also believed to improve the timeliness of care and equitable access to high quality care. Additional studies to compare these perspectives to those of other key stakeholders, including clinicians, hospital administrators and representatives of third party payers, will facilitate better understanding of the role of multidisciplinary care programs in lung cancer care delivery.
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Satish K
authors.initials: SK
authors.lastname: Kedia
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Ward
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Siri A
authors.initials: SA
authors.lastname: Digney
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Bianca M
authors.initials: BM
authors.lastname: Jackson
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: April L
authors.initials: AL
authors.lastname: Nellum
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: McHugh
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Kristina S
authors.initials: KS
authors.lastname: Roark
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Orion T
authors.initials: OT
authors.lastname: Osborne
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Fayre J
authors.initials: FJ
authors.lastname: Crossley
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Faris
authors.affiliation: 1 School of Public Health, University of Memphis, Memphis, TN, USA ; 2 Focus Group Task Force, Thoracic Oncology Research Group; 3 Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis, TN, USA ; 4 Alliance for Nonprofit Excellence, Memphis, TN, USA.
authors.forename: Raymond U
authors.initials: RU
authors.lastname: Osarogiagbon
keywords: Quality of care; focus groups; multidisciplinary model; patient-centered care; qualitative analysis; serial care model