title: Supporting Patients With Incurable Cancer: Backup Behavior in Multidisciplinary Cross-Functional Teams.
abstract: Caring for patients with incurable cancer presents unique challenges. Managing symptoms that evolve with changing clinical status and, at the same time, ensuring alignment with patient goals demands specific attention from clinicians. With care needs that often transcend traditional service provision boundaries, patients who seek palliation commonly interface with a team of providers that represents multiple disciplines across multiple settings. In this case study, we explore some of the dynamics of a cross-disciplinary approach to symptom management in an integrated outpatient radiotherapy service model. Providers who care for patients with incurable cancer must rely on one another to secure delivery of the right services at the right time by the right person. In a model of shared responsibilities, flexibility in who does what and when can enhance overall team performance. Adapting requires within-team and between-team monitoring of task and function execution for any given patient. This can be facilitated by a common understanding of the purpose of the clinical team and an awareness of the particular circumstances surrounding care provision. Backup behavior, in which one team member steps in to help another meet an expectation that would otherwise not be fulfilled, is a supportive team practice that may follow naturally in high-functioning teams. Such team processes as these have a place in the care of patients with incurable cancer and help to ensure that individual provider efforts more effectively translate into improved palliation for patients with unmet needs.
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Fleur
authors.initials: F
authors.lastname: Huang
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Amy
authors.initials: A
authors.lastname: Driga
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Bronwen E
authors.initials: BE
authors.lastname: LeGuerrier
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Renée
authors.initials: R
authors.lastname: Schmitz
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Debra M
authors.initials: DM
authors.lastname: Hall-Lavoie
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Xanthoula
authors.initials: X
authors.lastname: Kostaras
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Karen P
authors.initials: KP
authors.lastname: Chu
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Edith
authors.initials: E
authors.lastname: Pituskin
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Watanabe
authors.affiliation: University of Alberta Faculty of Medicine and Dentistry; Cross Cancer Institute, Alberta Health Services; University of Alberta Faculty of Rehabilitation Medicine; University of Alberta Faculty of Nursing, Edmonton, Alberta; University of Calgary School of Medicine; and Guideline Resource Unit, Alberta Health Services, Calgary, Alberta, Canada.
authors.forename: Alysa
authors.initials: A
authors.lastname: Fairchild
mesh_terms: D001859:Bone Neoplasms / Q000532:radiotherapy / Q000556:secondary / Q000628:therapy*; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D008875:Middle Aged; D010166:Palliative Care; D010348:Patient Care Team / Q000458:organization & administration*