How do organisational characteristics influence teamwork and service delivery in lung cancer diagnostic assessment programmes? A mixed-methods study

Objectives: Diagnostic assessment programs (DAPs) can reduce wait times for cancer diagnosis but optimal DAP design is unknown. This study explored how organizational characteristics influenced multidisciplinary teamwork and diagnostic service delivery in lung cancer DAPs. Design: A mixed methods approach integrated data from descriptive qualitative interviews and medical record abstraction at four lung cancer DAPs. Findings were analyzed with the Integrated Team Effectiveness Model. Setting: Four DAPs at two teaching and two community hospitals in Canada Participants: Twenty-two staff were interviewed about organizational characteristics, target service benchmarks, and teamwork processes, determinants and outcomes; 314 medical records were reviewed for actual service benchmarks. Results: Formal, informal and asynchronous team processes enabled service delivery and yielded many perceived benefits at the patient, staff and service levels. However, several DAP characteristics challenged t...