Table 3 Models of co-operation in multidisciplinary cancer care
1. Advisory committee | 2. Formal co-adaptation | 3. Integrated care process | |
|---|---|---|---|
Cases submitted (approx. %) | "Complex" cases or off-protocol: 10% - 50% | All "possible" cases: 50% - 80% | Initial source of clinical assessment: 90%-100% |
Patient access to team | Treatment (whether or not initiated) | Diagnosis or treatment | Suspect or diagnosis (early access) |
Nature of agreements | Recommendations | Consensus decisions not always implemented | Binding decisions defended by the team |
Professional team roles | Negative perception | Chair, tumour board co-ordinator | Chair, co-ordinator, nurse case manager |
Impact on clinical process management | Minor changes | Some segments of care | Whole process (cross-boundary frequent) |
Specialist participation | No diagnostic specialisations | Absences due only to timetable problems | Professionals associated with a clinical committee |
Junior doctors and nursing role, in terms of attendance | Considered inappropriate | Open meeting, participation encouraged | Mandatory presence |
Hospital executive board role | Lack of interest | Acknowledgement without express support | Express support (room, clerk, etc.) |
Presence in health system | 40% | 50% | 10% |