Data from: 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 teamwork and service delivery: referral
volume/workload, time since launch, days per week of operation,
rural-remote population, number and type of full-time/part-time human
resources, staff co-location, information systems. As a result, all sites
failed to meet target benchmarks (from referral to consultation median 4.0
visits, median wait time 35.0 days). Recommendations included improved
information systems, more staff in all specialties, staff co-location and
expanded roles for patient navigators. Findings were captured in a
conceptual framework of lung cancer DAP teamwork determinants and
outcomes. Conclusions: This study identified several DAP characteristics
that could be improved to facilitate teamwork and enhance service
delivery, thereby contributing to knowledge of organizational determinants
of teamwork and associated outcomes. Findings can be used to update
existing DAP guidelines, and by managers to plan or evaluate lung cancer
DAPs. Ongoing research is needed to identify ideal roles for navigators,
and staffing models tailored to case volumes.