Abstract
Lung cancer (lc) is a complex disease requiring coordination of multiple health care professionals. A recently implemented lc multidisciplinary clinic (mdc) at Kingston Health Sciences Centre, an academic tertiary care hospital, improved timeliness of oncology assessment and treatment. This study describes patient, caregiver, and physician experiences in the mdc. We qualitatively studied patient, caregiver, and physician experiences in a traditional siloed care model and in the mdc model. We used purposive sampling to conduct semi-structured interviews with patients and caregivers who received care in one of the models and with physicians who worked in both models. Thematic design by open coding in the ATLAS.ti software application (ATLAS.ti Scientific Software Development, Berlin, Germany) was used to analyze the data. Participation by 6 of 72 identified patients from the traditional model and 6 of 40 identified patients from the mdc model was obtained. Of 9 physicians who provided care in both models, 8 were interviewed (2 respirologists, 2 medical oncologists, 4 radiation oncologists). Four themes emerged: communication and collaboration, efficiency, quality of care, and effect on patient outcomes. Patients in both models had positive impressions of their care. Patients in the mdc frequently reported convenience and a positive effect of family presence at appointments. Physicians reported that the mdc improved communication and collegiality, clinic efficiency, patient outcomes and satisfaction, and consistency of information provided to patients. Physicians identified lack of clinic space as an area for mdc improvement. This qualitative study found that a lc mdc facilitated patient communication and physician collaboration, improved quality of care, and had a perceived positive effect on patient outcomes.
Highlights
Lung cancer is the leading cause of cancer-related mortality, with a 5-year survival of less than 20%1
Physicians reported that the mdc improved communication and collegiality, clinic efficiency, patient outcomes and satisfaction, and consistency of information provided to patients
For the specified time frames, we identified from the database 182 patients seen in the traditional model of care and 77 patients seen in the mdc model of care
Summary
Lung cancer (lc) is the leading cause of cancer-related mortality, with a 5-year survival of less than 20%1. Multidisciplinary clinic (mdc) models have demonstrated effectiveness in patient management for other cancer types[9,10]. Mdcs are uncommon in lc care[5], and until recently, there has been a paucity of data supporting their implementation for this patient group[11,12]. Evidence is increasingly showing that lc mdcs might improve care coordination, communication between providers, and compliance with guidelines, and might reduce delays in diagnosis and treatment[11,12,13,14]. Very few studies have evaluated the effect of lc mdcs on patient and health care provider experiences[5,12,18]. A recently implemented lc multidisciplinary clinic (mdc) at Kingston Health Sciences Centre, an academic tertiary care hospital, improved timeliness of oncology assessment and treatment. This study describes patient, caregiver, and physician experiences in the mdc
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