TY - JOUR
T1 - Resolving rivalries and realigning goals
T2 - Challenges of clinical and research multiteam systems
AU - Gerber, David E.
AU - Reimer, Torsten
AU - Williams, Erin L.
AU - Gill, Mary
AU - Priddy, Laurin Loudat
AU - Bergestuen, Deidi
AU - Schiller, Joan H.
AU - Kirkpatrick, Haskell
AU - Lee, Simon J Craddock
N1 - Funding Information:
The production of this manuscript was funded by the Conquer Cancer Foundation Mission Endowment. This work was supported by a National Cancer Institute Midcareer Investigator Award in Patient-Oriented Research, No. K24CA201543-01 (D.E.G.); the University of Texas Southwestern Center for Patient-Centered Outcomes Research, No. AHRQ 1R24HS022418-01 (S.J.C. L.); and the Harold C. Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, which is supported in part by a National Cancer Institute Cancer Center Support Grant, No. 1P30 CA142543- 03. D.E.G. and T.R. contributed equally to this work. We thank Dru Gray for assistance with manuscript preparation and Helen Mayo, MLS, from the University of Texas Southwestern Medical Library, for assistance with literature searches.
Publisher Copyright:
Copyright © 2016 by American Society of Clinical Oncology.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. The case highlights the concept of multiteam systems in cancer clinical research and clinical care. Because clinical research represents a highly dynamic entity-with studies frequently opening, closing, and undergoing modifications-concerted efforts of multiple teams are needed to respond to these changes while continuing to provide consistent, high-level careand timely, accurate clinical data. The case illustrates typical challenges of multiteam care processes. Compared with clinical tasks that are routinely performed by single teams, multiple-team care greatly increases the demands for communication, collaboration, cohesion, and coordination among team members. As the case illustrates, the described research team and clinical team are separated, resulting in suboptimal function. Individual team members interact predominantly with members of their own team. A considerable number of team members lack regular interaction with anyone outside their team. Accompanying this separation, the teams enact rivalries that impede collaboration. The teams have misaligned goals and competing priorities that create competition. Collective identity and cohesion across the two teams are low. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided. Clinical providers and researchers may incorporate these themes into development and evaluation of multiteam systems, multidisciplinary teams, and cross-functional teams within their own institutions.
AB - This article describes the care processes for a 64-year-old man with newly diagnosed advanced non-small-cell lung cancer who was enrolled in a first-line clinical trial of a new immunotherapy regimen. The case highlights the concept of multiteam systems in cancer clinical research and clinical care. Because clinical research represents a highly dynamic entity-with studies frequently opening, closing, and undergoing modifications-concerted efforts of multiple teams are needed to respond to these changes while continuing to provide consistent, high-level careand timely, accurate clinical data. The case illustrates typical challenges of multiteam care processes. Compared with clinical tasks that are routinely performed by single teams, multiple-team care greatly increases the demands for communication, collaboration, cohesion, and coordination among team members. As the case illustrates, the described research team and clinical team are separated, resulting in suboptimal function. Individual team members interact predominantly with members of their own team. A considerable number of team members lack regular interaction with anyone outside their team. Accompanying this separation, the teams enact rivalries that impede collaboration. The teams have misaligned goals and competing priorities that create competition. Collective identity and cohesion across the two teams are low. Research team and clinical team members have limited knowledge of the roles and work of individuals outside their team. Recommendations to increase trust and collaboration are provided. Clinical providers and researchers may incorporate these themes into development and evaluation of multiteam systems, multidisciplinary teams, and cross-functional teams within their own institutions.
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U2 - 10.1200/JOP.2016.013060
DO - 10.1200/JOP.2016.013060
M3 - Article
C2 - 27624948
AN - SCOPUS:85011588645
SN - 1554-7477
VL - 12
SP - 1020
EP - 1028
JO - Journal of Oncology Practice
JF - Journal of Oncology Practice
IS - 11
ER -