title: Care for a Patient With Cancer As a Project: Management of Complex Task Interdependence in Cancer Care Delivery.
abstract: Cancer care is highly complex and suffers from fragmentation and lack of coordination across provider specialties and clinical domains. As a result, patients often find that they must coordinate care on their own. Coordinated delivery teams may address these challenges and improve quality of cancer care. Task interdependence is a core principle of rigorous teamwork and is essential to addressing the complexity of cancer care, which is highly interdependent across specialties and modalities. We examined challenges faced by a patient with early-stage breast cancer that resulted from difficulties in understanding and managing task interdependence across clinical domains involved in this patient's care. We used team science supported by the project management discipline to discuss how various task interdependence aspects can be recognized, deliberately designed, and systematically managed to prevent care breakdowns. This case highlights how effective task interdependence management facilitated by project management methods could markedly improve the course of a patient's care. This work informs efforts of cancer centers and practices to redesign cancer care delivery through innovative, practical, and patient-centered approaches to management of task interdependence in cancer care. Future patient-reported outcomes research will help to determine optimal ways to engage patients, including those who are medically underserved, in managing task interdependence in their own care.
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Julia R
authors: JR
authors: Trosman
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Ruth C
authors: RC
authors: Carlos
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Melissa A
authors: MA
authors: Simon
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Debra L
authors: DL
authors: Madden
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: William J
authors: WJ
authors: Gradishar
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Al B
authors: AB
authors: Benson
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Bruce D
authors: BD
authors: Rapkin
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Elisa S
authors: ES
authors: Weiss
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Ilana F
authors: IF
authors: Gareen
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Lynne I
authors: LI
authors: Wagner
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Seema A
authors: SA
authors: Khan
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Mikele M
authors: MM
authors: Bunce
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Art
authors: A
authors: Small
authors: Center for Business Models in Healthcare; Northwestern University, Chicago, IL; University of Michigan Health System; University of Michigan Medical School, Ann Arbor, MI; ECOG/ACRIN Cancer Research Group, Philadelphia, PA; National Breast Cancer Coalition, Washington, DC; Genentech, South San Francisco, CA; Albert Einstein Cancer Center; Albert Einstein College of Medicine, Bronx; The Leukemia & Lymphoma Society, Rye Brook, NY; Brown University School of Public Health, Providence, RI; Wake Forest University School of Medicine; and Comprehensive Cancer Center of Wake Forest University, Winston-Salem, NC.
authors: Christine B
authors: CB
authors: Weldon
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000628:therapy*; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D006801:Humans; D006278:Medicare; D020360:Neoadjuvant Therapy; D010348:Patient Care Team / Q000458:organization & administration*; D014481:United States