Three doctors in discussion

Teams in Cancer Care Delivery 

The National Cancer Institute (NCI) and the American Society of Clinical Oncology launched the Teams in Cancer Care Delivery project, with the goal of applying the science of team-based care to oncology. In February 2016, teams of clinicians, researchers, and patient advocates gathered for the NCI-ASCO Teams in Cancer Care Delivery Workshop. During the Workshop, teams presented and shared clinical scenarios illustrating models of team-based care. Many of these teams have submitted manuscripts on the topic to the November 2016 issue of the Journal of Oncology Practice (JOP).

If you have any questions, please send an email to Teams in Cancer Care Delivery. 

Project Goals

The Teams in Cancer Care Delivery project will focus on several goals:

  • Exploring team principles:
    • Task interdependence
    • Teamwork
    • Coordinating mechanisms
    • Situational monitoring
    • Team leadership
    • Mutual performance monitoring
    • Backup behavior
    • Team orientation
    • Shared problem-solving and decision-making
    • Conflict resolution/management
    • Planning, goal-setting, and role definition
    • Team composition/diversity
    • Joint cognition
  • Investigating how team principles can can be applied at all stages across the cancer care continuum:
    • Asymptomatic
    • Symptomatic
    • Diagnosed
    • Under treatment
    • Seeking palliation
    • At the end of life
    • Survivorship
  • Providing the clinical oncology community with practical strategies for organizing effective healthcare teams.
  • Identifying areas that will lay the foundation for team research in cancer care delivery. These areas include taxonomy, operational definitions, and measurement.

Presentations From the 2016 NCI-ASCO Teams in Cancer Care Delivery Workshop

Expanding the Scientific Evidence for Healthcare Teams in Cancer Care (Kosty M, Taplin S): Establishes the real world need for research into team-based care in oncology. This presentation also establishes the research goals of the NCI-ASCO collaboration. The authors define the term "team" and identify the eight hallmark behaviors of effective teams.

Health Care Teams in Cancer Care (Taplin SH, et al.): Establishes the connection between teams-research and cancer care, and draws on previous research to show how research can improve care.

Importance of Patient Advocates in Teams (Smith ML): Defines the role of the patient advocate in advancing team-based cancer care. Discusses how involving advocates can add value to this area of research. The author emphasizes how effective communication can simplify and improve the patient experience.

Coordination of Care with a Multidisciplinary Care Team During Treatment (Byar, et al.): Describes the key principles of coordination of care in a multidisciplinary team setting. The case study demonstrates how coordination mechanisms play an important role in developing seamless care between healthcare practices of all sizes and location.

Use of a Shared Mental Model by a Team Comprised of Oncology, Palliative Care, and Supportive Care Clinicians to Facilitate Shared Decision-Making in a Patient with Advanced Cancer (D’Ambruoso, et al.) Describes the concept of a shared mental model (SMM) and its application to interdisciplinary team work. The case study discusses the experience of a team of oncologists and palliative care specialists working off of a consciously developed SMM. The study demonstrates the oncologists’ successes and challenges with the model.

Challenges and Promises of Multi-Team Care (Gerber, et al.): Defines multi-disciplinary teams, cross-functional teams, and multi-team systems. The authors make recommendations for mitigating the challenges faced by multi-team systems.

Shared Goal Setting in Team-Based Geriatric Cancer (Magnuson, et al.): Defines shared goal setting and its three primary mechanisms. The case study demonstrates how not explicitly stating individual goals can prevent teams from establishing critical shared goals.

Using Team Mental Models and Transactive Memory to Deliver Coordinated Cancer Care (Henry, et al.): Describes the principle of transactive memory systems and its components. The case study applies this principle to a multi-team system using a “boundary spanning” team model.

Shared Goals Empower Teams in Complex Care Delivery (Hesse, et al.): Defines joint cognition, project management, collaborative goal setting, and backup behavior. Outlines the limits of each of these objectives in the current healthcare delivery system.

Backup Behavior: How Multidisciplinary Cross-Functional Teams Can Support Patients with Incurable Cancer (Huang, et al.): Describes backup behavior and the key structures and process that enable it. Reviews “good” and “bad” examples of backup behavior in practice.

Core Coordinating Mechanisms of Teamwork in Adolescent and Young Adult (AYA) Oncology (Johnson, et al.): Defines three core coordinating mechanisms of teamwork: Closed loop communication, shared mental models, and mutual trust. The case study examines the implications of implementing these mechanisms in an AYA care setting.

Highlighting Trust in the Provision of Cancer Care (Lazzara, et al.): Defines the term, “trust” and its implications for clinical care and research.

Achieving Coordinated Care for Complex Cancer Patients: A Multi-team System Approach (Lee, et al.): Identifies multi-team system elements useful in coordinating care for patients with multiple chronic conditions. The presentation emphasizes the importance of the shared mental model.

Team Science and Interdisciplinary Lung Cancer Care: Avoiding the Long and Winding Road (Osarogiagbon, et al.): Demonstrates several coordinating mechanisms of team work—closed loop communication, mutual trust, and shared mental models— in the context of lung cancer care. The authors identify opportunities for future research into lung-cancer care teams.

Leveraging a Team Mental Model to Develop a Cancer Anorexia Cachexia Syndrome Team (Portman, et al.): Defines the principle of the team mental model. Discusses a patient with anorexia cachexia to demonstrate how deficits in the team mental model impact the patient and caregiver.

Trust and Communication as Critical Variables of Teamwork (Reiter-Palmon, et al.): Discusses four team principles: coordination, multi-team systems, closed loop communication, and trust.

Care for a Cancer Patient as a Project: Managing Complex Task Interdependence in Cancer Care Delivery (Trosman, et al.): This presentation defines task interdependence in cancer care delivery. The case study demonstrates how breakdowns in care can occur when task interdependence is not managed. 

Additional Resources