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01.12.2017 | Research article | Ausgabe 1/2017 Open Access

BMC Health Services Research 1/2017

Effects of interdisciplinary teamwork on patient-reported experience of cancer care

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2017
Autoren:
Dominique Tremblay, Danièle Roberge, Nassera Touati, Elizabeth Maunsell, Djamal Berbiche
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​s12913-017-2166-7) contains supplementary material, which is available to authorized users.

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.
Zusatzmaterial
Additional file 1: ITW tool components and Patient-Reported Experience Measures (PREMs) questionnaire items. Description: Table S1. presents the interview grid items to determine ITW intensity, criteria and indicator for quantification of qualitative data. In reference to the PREMs questionnaire used in the study, questions in Table S2. were designed to measure the cancer experience from the patient’s perspective; questions in Table S3. were designed to document the sociodemographic, clinical, and organizational characteristics that were potential confounders. (PDF 106 kb)
12913_2017_2166_MOESM1_ESM.pdf
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