Multidisciplinary Care: How Small Practices, Hospitals Can Gain Support to Establish Teams

Multidisciplinary care teams have been recognized as an important part of comprehensive cancer care for many years; however, recently their central role has increased in importance. Multidisciplinary teams including physicians, nurses, administrators, financial advisors, patient navigators, and others help to ensure a collaborative consultation along a patient’s treatment pathway. Small practices and hospitals continue to look for strategies that will help to improve team cohesion while adding value to the patient.

At the Association for Community Cancer Centers 40th Annual National Meeting, Virginia T. Vaitones, MSW, OSW-C, president of the association, moderated a panel discussion of issues related to multidisciplinary care in oncology, including what advice panel members would give to smaller practices who want to create multidisciplinary teams but who might not have financial or C-suite support.

The first strategy discussed was attempting to gain C-suite support within your organization.

“The bottom line is there is value to accreditation and forming multidisciplinary teams,” said Linda Ferris, PhD, vice president, Oncology System Service Line, Centura Health Cancer Network.

Ferris suggested using the realities of the current care climate to sell the idea of multidisciplinary teams. Facilities are able to offer better quality care with an increased focus on outcomes and cost of care when a team is formed and the patient and their caregivers are put at the center of it.

“There is more and more pressure for publically reported outcomes, and you can only get that through forming multidisciplinary care,” she said. 

In addition to attempting to garner C-suite support, Mark Soberman, MD, MBA, FACS, medical director, Oncology Service Line, Frederick Regional Health System, suggested trying to find a physician champion within your organization.

“If you don’t get physician buy-in, you are not going to have a program,” Soberman said. “If you can find one person on the medical staff, one person on the oncology service line who will be that champion that is how you will be successful.”

Soberman said that at his organization, the first multidisciplinary care team was actually organized as a response to a recognized community need. Frederick Regional Health System is the sole provider of cancer care in their county and it found that most women were leaving the county for breast cancer care because there was no breast center available. A conversation between leaders, medical staff and the board of the hospital recognized this need and that led to an establishment of a multidisciplinary team.

When advocating for the establishment of multidisciplinary care teams it is also important to emphasis that the health care landscape in the United States is shifting to a more value-based, patient-centered system, and patients are at the center of a multidisciplinary team.

Organizations have to shift how they think about patients, according to Tom Kean, MPH, president and CEO of C-Change.

“We have to look at patients as an ongoing relationship, an ongoing set of communications that help us refine, deliver better value and better quality that is consistent with their needs,” Kean said.

Although the idea of creating change within your organization may seem overwhelming, every change starts somewhere and it can start small, added Marie Garcia, RN, OCN, of Virginia Cancer Specialists, PC.

For example, at her organization patient education started out very small as one-on-one meeting between nurses and patients. Now it has grown into a 2-hour seminar for every patient and their caregiver to come to.

Garcia suggested that if your organization cannot provide every aspect of care, such as nutritional support or financial support that it takes advantage of the resources that may be available within the community.

“If you don’t have resources within your own practices and institutions, we have ACCC, we have state organizations… integrate all those systems into your practice,” she said. “When people come through our doors we offer a variety of services and we make sure patients know that up front.”