Teamwork competencies for interprofessional cancer care in multiteam systems: A narrative synthesis

ABSTRACT

Numerous teamwork competency frameworks are designed for co-located, procedure-driven teams delivering care in acute settings. Little is known about their applicability or evaluation among larger teams-of-teams, known as multiteam systems (MTS), involved in delivering care for complex chronic conditions like cancer. In this review we aimed to identify studies examining teamwork competencies or teamwork competency frameworks developed or tested in healthcare teams, identify the extent to which they have been applied or evaluated in cancer care, and understand their applicability to larger MTSs involved in coordinating cancer care. We identified 107 relevant original articles, consensus statements, and prior systematic reviews published from 2013–2019. Most original papers (n = 96) were intervention studies of inpatient acute care teams (52, 54%). Fifty-eight articles (60%) used existing frameworks to define competency domains. Four original articles and two consensus statements addressed teamwork competencies for cancer care. Few frameworks or interprofessional education (IPE) curricula specifically addressed teamwork among larger, distributed teams or examined competencies necessary to overcome care coordination challenges in cancer care MTSs. Research guiding the development of frameworks and IPE that consider challenges to effective coordination among larger MTSs and studies of their impact on patient and clinical outcomes is essential to optimal, high-quality care.

KEYWORDS:

• Patient care team
• multiteam system
• competency-based education
• interprofessional education

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

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Additional information

Notes on contributors

Veronica Chollette

Veronica Chollette, RN, MS is a Program Director in the Health Systems and Interventions Research Branch (HSIRB) of the Healthcare Delivery Research Program. She has managed a portfolio of grants at NCI for over 30 years. In HSIRB, her training and experience allow her to manage NCI-funded social and behavioral research directed at multiple contextual levels to improve rates of cervical cancer screening and HPV vaccination; factors associated with disparities in Prostate Cancer, PSA screening and the downstream consequences following screening; and studies that improve interprofessional teamwork in healthcare delivery. She is a co-lead of the Healthcare Teams Initiative, which addresses multiple strategies to improve patient outcomes through healthcare delivery grounded in principles of evidence-based team research.

Michelle Doose

Michelle Doose, PhD, MPH, is a Cancer Prevention Fellow in the Health Systems and Interventions Research Branch of the Healthcare Delivery Research Program. Michelle’s research focuses on healthcare delivery and cancer care outcomes among cancer patients and survivors with complex health and social needs, using a health equity lens. She is particularly interested in understanding how multidisciplinary care teams coordinate cancer and comorbid care within and across healthcare systems and identifying modifiable points for interventions. Her previous research examined the multilevel factors (i.e., patient, provider, and health system) that influence clinical care management of diabetes and hypertension among Black women with breast cancer.

Janeth Sanchez

Janeth Sanchez PhD, MPH is a Program Director in the Health Systems and Interventions Branch (HSIRB) of the Healthcare Delivery Research Program. Dr. Sanchez’s scientific and programmatic interests are centered on advancing the science of health equity and improving cancer care delivery for health disparity populations. As Program Director, Dr. Sanchez will lead a research program focused on promoting multilevel interventions that mitigate the effects of care fragmentation, especially for underserved populations, and evaluating the impact of national policies on the equitable delivery of high-quality and cost-effective care across diverse populations. She currently leads several projects on understanding social determinants of health within the context of cancer care delivery.

Sallie J. Weaver

Sallie J. Weaver, PhD, MHS is a Program Director in the NCI Health Systems and Interventions Research Branch (HSIRB). She co-directs the NCI Healthcare Teams Initiative that aims to stimulate research examining teamwork and coordination in cancer care and to translate related interventions into practice. Dr. Weaver’s interests and research focus on organizational factors that influence team performance, and interventions designed to optimize patient safety, care quality, and coordination. This includes team and multi-team system performance, safety climate, and leadership. She has experience in both survey and quasi-experimental research methods, applying them to examine team and organizational performance outcomes and implementation strategies in acute and primary care settings both in the U.S. and internationally. Prior to joining NCI in October 2016, Sallie was an Associate Professor in Dept. of Anesthesiology and Critical Care Medicine at the Johns Hopkins School of Medicine. She was also core faculty in the Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality.