L’importanza dell’organizzazione in oncologia: collaborazione e coordinamento. Evidenze da una ricerca intervento sul tumore del polmone

Titolo Rivista MECOSAN
Autori/Curatori Americo Cicchetti, Roberta Laurita, Luca Giorgio
Anno di pubblicazione 2023 Fascicolo 2022/124
Lingua Italiano Numero pagine 19 P. 93-111 Dimensione file 0 KB
DOI 10.3280/mesa2022-124oa16271
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FrancoAngeli è membro della Publishers International Linking Association, Inc (PILA)associazione indipendente e non profit per facilitare (attraverso i servizi tecnologici implementati da CrossRef.org) l’accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche

Il coordinamento inter e intraorganizzativo è un tema chiave in ambito organizzativo, soprattutto nel settore sanitario. Nonostante sia disponibile un’ampia letteratura sul tema della gestione multidisciplinare in oncologia, gli studi esistenti non hanno completamente analizzato quali strutture, attori, strumenti e dinamiche sociali siano associati a un team clinico efficace. Questo studio, attraverso la ricerca-intervento, analizza le attuali modalità di gestione dei pazienti con carcinoma polmonare non a piccole cellule e propone un modello ottimale costituito da alcune linee guida organizzative, finalizzate a garantire una gestione efficace. Il presente modello si basa su tre pilastri aventi alla base: 1) le caratteristiche del team di gestione della malattia, 2) l’infrastruttura organizzativa che garantisce l’adozione dei percorsi clinici, 3) un sistema integrato di indicatori.;

Keywords:; team multidisciplinari; cancro; percorsi diagnostico terapeutici assistenziali; ricerca-intervento; miglioramento della qualità in sanità

  1. Taylor C., Munro A.J., Glynne-Jones R., Griffith C., Trevatt P., Richards M., & Ramirez A.J. (2010). Multidisciplinary team working in cancer: what is the evidence?. Bmj, 340.
  2. Addicott R., McGivern G., & Ferlie E. (2006). Networks, organizational learning and knowledge management: NHS cancer networks. Public Money and Management, 26(2): 87-94. DOI: 10.1111/j.1467-9302.2006.00506.x.
  3. Albano R. (2010). La ricerca intervento. In: Fabbri T.M., Solari L., Organizzare: concetti e metodi, Roma.
  4. Baldwin M. (2002). Co-operative inquiry as a tool for professional development. Systemic Practice and Action Research, 15(3): 223-235. DOI: 10.1023/A:1016392325258.
  5. Bradbury-Huang H. (2012). Value of action research in new healthcare: The importance of advancing action research through relational networks. Action Research, 10(4): 332-335. DOI: 10.1177/1476750312471841.
  6. Brown B.B., Patel C., McInnes E., Mays N., Young J., & Haines M. (2016). The effectiveness of clinical networks in improving quality of care and patient outcomes: a systematic review of quantitative and qualitative studies. BMC health services research, 16(1): 360. DOI: 10.1186/s12913-016-1615-z.
  7. Buja A., Paganini M., Cocchio S., Scioni M., Rebba V., & Baldo V. (2020). Demographic and socio-economic factors, and healthcare resource indicators associated with the rapid spread of COVID-19 in Northern Italy: An ecological study. PLoS One, 15(12): e0244535.
  8. Butera F. (1980). La ricerca intervento. In: Bontadini P., Gasparini G. (Eds.). Teoria della organizzazione e realtà italiana: problemi e contributi. Milano: FrancoAngeli.
  9. Carrato A., Vergnenègre A., Thomas M., McBride K., Medina J., & Cruciani G. (2014). Clinical management patterns and treatment outcomes in patients with non-small cell lung cancer (NSCLC) across Europe: EPICLIN-Lung study. Current medical research and opinion, 30(3): 447-461. DOI: 10.1185/03007995.2013.860372.
  10. Cicchetti A. (2013) (a cura di). I dipartimenti ospedalieri nel Ssn: Origini, evoluzione e prospettive. Milano: FrancoAngeli.
  11. Cicchetti A. (2018). L’organizzazione: la migliore medicina, X Rapporto sulla condizione assistenziale dei malati oncologici. Roma: FAVO.
  12. Corral J., Espinàs J.A., Cots F., Pareja L., Solà J., Font R., & Borràs J.M. (2015). Estimation of lung cancer diagnosis and treatment costs based on a patient-level analysis in Catalonia (Spain). BMC health services research, 15(1): 70. DOI: 10.1186/s12913-015-0725-3.
  13. Croke J.M., El-Sayed S. (2012). Multidisciplinary management of cancer patients: chasing a shadow or real value? An overview of the literature. Current Oncology, 19(4): e232-e238. DOI: 10.3747/co.19.944.
  14. Cropper S., Hopper A., & Spencer S.A. (2002). Managed clinical networks. Archives of Disease in Childhood, 87(1): 1-4. DOI: 10.1136/adc.87.1.1.
  15. Denscombe M. (2007). The Good Research Guide: For Small-Scale Social Research Projects. London: McGraw-Hill.
  16. Doroshow D.B., Sanmamed M.F., Hastings K., Politi K., Rimm D.L., Chen L., Melero I., Schalper K.A., & Herbst R.S. (2019). Immunotherapy in Non-Small Cell Lung Cancer: Facts and Hopes. Clin Cancer Res., 25(15): 4592-4602.
  17. 1158/1078-0432.CCR-18-1538.
  18. Duggleby W. (2005). What About Focus Group Interaction Data?. Qualitative Health Research, 15(6): 832-840. DOI: 10.1177/1049732304273916.
  19. Eberhardt W.E., De Ruysscher D., Weder W., Le Péchoux C., De Leyn P., Hoffmann H., Westeel V., Stahel R., Felip E., Peters S., & Panel Members (2015). 2nd ESMO Consensus Conference in Lung Cancer: locally advanced stage III non-smallcell lung cancer. Ann Oncol., 26(8): 1573-1588. DOI: 10.1093/annonc/mdv187.
  20. Edwards N. (2002). Clinical networks: Advantages include flexibility, strength, speed, and focus on clinical issues. BMJ, 324: 63. DOI: 10.1136/bmj.324.7329.63.
  21. Fennell M.L., Das I.P., Clauser S., Petrelli N., & Salner A. (2010). The organization of multidisciplinary care teams: modeling internal and external influences on cancer care quality. Journal of the National Cancer Institute. Monographs, (40): 72-80. DOI: 10.1093/jncimonographs/lgq010.
  22. Ferlay J., Soerjomataram I., Dikshit R., Eser S., Mathers C., Rebelo M., Parkin D.M., Forman D., & Bray F. (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN. Int J Cancer, 136(5): E359-86. DOI: 10.1002/ijc.29210.
  23. Fleissig A., Jenkins V., Catt S., & Fallowfield L. (2006). Multidisciplinary teams in cancer care: are they effective in the UK?. The lancet oncology, 7(11): 935-943.
  24. Fleming I., Monaghan P., Gavin A., & O’Neill C. (2008). Factors influencing hospital costs of lung cancer patients in Northern Ireland. The European Journal of Health Economics, 9(1): 79-86. DOI: 10.1007/s10198-007-0047-4.
  25. Fulop N.J., & Ramsay A.I. (2019). How organisations contribute to improving the quality of healthcare. BMJ, 365: l1773. DOI: 10.1136/bmj.l1773.
  26. Gorin S.S., Haggstrom D., Han P.K., Fairfield K. M., Krebs P., & Clauser S.B. (2017). Cancer care coordination: a systematic review and meta-analysis of over 30 years of empirical studies. Annals of Behavioral Medicine, 51(4): 532-546. DOI: 10.1007/s12160-017-9876-2.
  27. Gort M., Broekhuis M., & Regts G. (2013). How teams use indicators for quality improvement – A multiple-case study on the use of multiple indicators in multidisciplinary breast cancer teams. Social Science & Medicine, 96(C): 69-77. DOI: 10.1016/j.socscimed.2013.06.001.
  28. Grandori A. (1996). Disegni di ricerca in organizzazione. In: Costa G., Nacamulli R.C.D. (Eds.). Manuale di zrganizzazione Aziendale: vol. 5, Metodi e tecniche di analisi e di intervento. Torino: Utet.
  29. Granja C., Janssen W., & Johansen M.A. (2018). Factors Determining the Success and Failure of eHealth Interventions: Systematic Review of the Literature. J Med Internet Res., 20(5): e10235. DOI: 10.2196/10235.
  30. Helfrich C.D., Weiner B.J., McKinney M.M., & Minasian L. (2007). Determinants of implementation effectiveness: adapting a framework for complex innovations. Medical care research and review, 64(3): 279-303. DOI: 10.1177/1077558707299887.
  31. Hughes A.M., Gregory M.E., Joseph D.L., Sonesh S.C., Marlow S.L., Lacerenza C.N., Benishek L.E., King H.B., & Salas E. (2016). Saving lives: A meta-analysis of team training in healthcare. J Appl Psychol., Sep., 101(9): 1266-1304. DOI: 10.1037/apl0000120.
  32. Huxham C., & Vangen S. (2003). Researching organizational practice through action research: Case studies and design choices. Organizational Research Methods, 6(3): 383-403. DOI: 10.1177/1094428103254454.
  33. Kitzinger J. (1994). The Methodology of Focus Groups: The Importance of Interaction between Research Participants. Sociology of Health & Illness, 16: 103-121. DOI: 10.1111/1467-9566.ep11347023.
  34. Maharaj S., Brahim A., Brown H. et al. (2020). Identifying dispensing errors in pharmacies in a medical science school in Trinidad and Tobago. J of Pharm Policy and Pract, 13(67). DOI: 10.1186/s40545-020-00263.
  35. Malterud K. (2012). Systematic text condensation: a strategy for qualitative analysis. Scandinavian journal of public health, 40(8): 795-805. DOI: 10.1177/1403494812465030.
  36. Morabito A. (2016). The evolution of the treatment of advanced NSCLC. Recenti Prog Med, 107(10): 510-514. DOI: 10.1701/2454.25700.
  37. Morgan D.L. (1996). Focus groups as qualitative research. Thousand Oaks: SAGE publications.
  38. Novello S., Barlesi F., Califano R., Cufer T., Ekman S., Levra M.G., Kerr K., Popat S., Reck M., Senan S., Simo G.V., Vansteenkiste J., Peters S., & ESMO Guidelines Committee (2016). Metastatic non-small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol., 27(5): v1-v27. DOI: 10.1093/annonc/mdw326.
  39. Ottevanger N., Hilbink M., Weenk M., Janssen R., Vrijmoeth T., de Vries A., & Hermens R. (2013). Oncologic multidisciplinary team meetings: evaluation of quality criteria. Journal of evaluation in clinical practice, 19(6): 1035-1043.
  40. Pan C.C., Kung P.T., Wang Y.H., Chang Y.C., Wang S.T., & Tsai W.C. (2015). Effects of multidisciplinary team care on the survival of patients with different stages of non-small cell lung cancer: a national cohort study. PloS one, 10(5): e0126547. DOI: 10.1371/journal.pone.0126547.
  41. Panella M., Marchisio S., Di Stanislao F. (2003). Reducing clinical variations with clinical pathways: do pathways work?. International Journal for Quality in Health Care, 15(6): 509-521. DOI: 10.1093/intqhc/mzg057.
  42. Prades J., Remue E., Van Hoof E., & Borras J.M. (2015). Is it worth reorganising cancer services on the basis of multidisciplinary teams (MDTs)? A systematic review of the objectives and organisation of MDTs and their impact on patient outcomes. Health Policy, 119(4): 464-474. DOI: 10.1016/j.healthpol.2014.09.006.
  43. Reason P., & Bradbury H. (2008). Editorial. Action Research, 6(1): 5-6. DOI: 10.1177/1476750308089760.
  44. Salas-Vega S., Iliopoulos O., & Mossialos E. (2017). Assessment of Overall Survival, Quality of Life, and Safety Benefits Associated With New Cancer Medicines. JAMA Oncol., Mar 1; 3(3): 382-390. DOI: 10.1001/jamaoncol.2016.4166.
  45. Soukup T., Lamb B.W., Arora S., Darzi A., Sevdalis N., & Green J.S. (2018). Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. Journal of multidisciplinary healthcare, 11: 49-61. DOI: 10.2147/JMDH.S117945.
  46. Stone E., Rankin N., Kerr S., Fong K., Currow D.C., Phillips J., Connon T., Zhang L., & Shaw T. (2018). Does presentation at multidisciplinary team meetings improve lung cancer survival? Findings from a consecutive cohort study. Lung ancer, 124: 199-204. DOI: 10.1016/j.lungcan.2018.07.032.
  47. Vansteenkiste J.D., De Ruysscher W.E.E., Eberhardt E., Lim S., Senan E., Felip S. Peters, on behalf of the ESMO Guidelines Working Group (2014). Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 24: vi89-vi98. DOI: 10.1093/annonc/mdt241.
  48. Waterman H., Tillen D., Dickson R., & De Koning K. (2001). Action research: A systematic review and assessment for guidance. Health Technology Assessment, 5(23): 1-166.
  49. Weaver S.J., Dy S.M., Rosen M.A. (2014). Team-training in healthcare: a narrative synthesis of the literature. BMJ Qual Saf., May, 23(5): 359-72. DOI: 10.1136/bmjqs-2013-001848.
  50. Weller J., Boyd M., & Cumin D. (2014). Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgraduate medical journal, 90(1061): 149-154.
  51. West M.A., & Lyubovnikova J. (2013). Illusions of team working in health care. Journal of health organization and management, 27(1): 134-142.
  52. Yorks L., & Nicolaides A. (2007). The role conundrums of co-inquiry action research: Lessons from the field. Systemic Practice and Action Research, 20(1): 105-116. DOI: 10.1007/s11213-006-9053-1.

Americo Cicchetti, Roberta Laurita, Luca Giorgio, L’importanza dell’organizzazione in oncologia: collaborazione e coordinamento. Evidenze da una ricerca intervento sul tumore del polmone in "MECOSAN" 124/2022, pp 93-111, DOI: 10.3280/mesa2022-124oa16271