Effects of interdisciplinary teamwork on patient-reported experience of cancer care.
Interdisciplinary teamwork (ITW) is deemed necessary for quality cancer care practices. Nevertheless, variation in ITW intensity among cancer teams is understudied, and quantitative evidence of the effect of different ITW intensities among cancer teams on patients' perceived experience of care is limited. This study aims to compare patient-reported experience measures (PREMs) of cancer outpatients followed by teams characterized by high vs. low ITW intensity.



The study is designed as an ex post facto quasi-experimental study. Participants (n = 1379) were recruited in nine outpatient oncology clinics characterized by different ITW intensities. ITW intensities were evaluated using the characteristics of structure (team composition and size) and process (interactions among team members), as per West's seminal work on team effectiveness. ITW intensity was dichotomized (high vs. low ITW intensity). PREMs were classified and measured using validated scales corresponding to six dimensions: Prompt access to care, Person-centred response, Quality of patient-professional communication, Quality of the care environment, Continuity of care, and Results of care. Dichotomous variables were created for each dimension (positive vs. less positive experience). Multiple logistic regression analyses were performed to assess the association between ITW intensities and the six PREMs dimensions, while controlling for patient and organizational characteristics. PROC GENMOD was used to fit logistic models for categorical variables.



Outpatients treated by teams characterized by high ITW intensity reported almost four times more positive perceptions of Prompt access to care compared to patients treated by low ITW intensity teams (OR = 3.99; CI = 1.89-8.41). High ITW intensity also positively affected patients' perceptions of Quality of patient-professional communication (OR = 2.37; CI = 1.25-4.51), Person-centred response (OR = 2.11; CI = 1.05-4.24], and Continuity of care (OR = 2.18; CI = 1.07-4.45). No significant association was found between ITW intensity and perceived Results of care (OR = 1.31; CI = 0.68-2.52) or Quality of the care environment (OR = 0.66; CI = 0.31-1.39).



This study provides empirical evidence, from the patient's perspective, that ITW intensity affects some critical aspects of patient-reported quality of care. Future research will allow explaining how and why ITW structure and processes may contribute to positive cancer care experiences.
Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Quebec, Canada. dominique.tremblay2@usherbrooke.ca.|Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada. dominique.tremblay2@usherbrooke.ca.
Dominique
0000-0002-1798-5681
D
Tremblay
Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada.|Department of Community Health Sciences, Faculty of Medicine and Health Sciences, Université de Sherbrooke (Longueuil Campus), Longueuil, Quebec, Canada.
Danièle
D
Roberge
École nationale d'administration publique, Montreal, Quebec, Canada.
Nassera
N
Touati
Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Québec City, Quebec, Canada.
Elizabeth
E
Maunsell
Charles-Le Moyne Hospital Research Center, Greenfield Park, Quebec, Canada.
Djamal
D
Berbiche
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010465:Perception; D011787:Quality of Health Care; D012423:Rural Health / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014504:Urban Health / Q000706:statistics & numerical data; D055815:Young Adult
Cancer care; Interdisciplinary teamwork; Patient care team; Patient-reported experience measures; Quasi-experimental study