Multidisciplinary cancer care in Spain, or when the function creates the organ: qualitative interview study

BMC Public Health

Research Article

Joan Prades¹  Josep M Borràs² 

[1] Catalan Cancer Plan, Hospital Duran i Reynals, 199-203 Avenue Gran Via de l'Hospitalet, 08908, Hospitalet de Llobregat, Spain;Catalan Cancer Plan, Hospital Duran i Reynals, 199-203 Avenue Gran Via de l'Hospitalet, 08908, Hospitalet de Llobregat, Spain;Clinical Sciences Department, Institut de Recerca Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, 199-203 Avenue Gran Via de l'Hospitalet, 08908, Hospitalet de Llobregat, Spain;

关键词: Cancer Care;    Tumour Board;    Multidisciplinary Care;    Multidisciplinary Meeting;    Nurse Case Manager;   

DOI  :  10.1186/1471-2458-11-141

 received in 2010-09-22, accepted in 2011-02-28,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe Spanish National Health System recognised multidisciplinary care as a health priority in 2006, when a national strategy for promoting quality in cancer care was first published. This institutional effort is being implemented on a co-operative basis within the context of Spain's decentralised health care system, so a high degree of variability is to be expected. This study was aimed to explore the views of professionals working with multidisciplinary cancer teams and identify which barriers to effective team work should be considered to ensure implementation of health policy.MethodsQualitative interview study with semi-structured, one-to-one interviews. Data were examined inductively, using content analysis to generate categories and an explanatory framework. 39 professionals performing their tasks, wholly or in part, in different multidisciplinary cancer teams were interviewed. The breakdown of participants' medical specialisations was as follows: medical oncologists (n = 10); radiation oncologists (n = 8); surgeons (n = 7); pathologists or radiologists (n = 6); oncology nurses (n = 5); and others (n = 3).ResultsTeams could be classified into three models of professional co-operation in multidisciplinary cancer care, namely, advisory committee, formal co-adaptation and integrated care process. The following barriers to implementation were posed: existence of different gateways for the same patient profile; variability in development and use of clinical protocols and guidelines; role of the hospital executive board; outcomes assessment; and the recording and documenting of clinical decisions in a multidisciplinary team setting. All these play a key role in the development of cancer teams and their ability to improve quality of care.ConclusionCancer team development results from an specific adaptation to the hospital environment. Nevertheless, health policy plays an important role in promoting an organisational approach that changes the way in which professionals develop their clinical practice.

【 授权许可】

CC BY   
© Prades and Borràs; licensee BioMed Central Ltd. 2011