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How do the characteristics of breast cancer diagnostic assessment programmes influence service delivery: A mixed methods study
Author(s) -
Gagliardi A.R.,
HoneinAbouHaidar G.,
StuartMcEwan T.,
Smylie J.,
Arnaout A.,
Seely J.,
Wright F.C.,
Dobrow M.J.,
Brouwers M.C.,
Bukhanov K.,
McCready D.R.
Publication year - 2018
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12727
Subject(s) - medicine , referral , service delivery framework , teamwork , nursing , service (business) , patient satisfaction , breast cancer , family medicine , multidisciplinary approach , medical record , medical emergency , cancer , surgery , social science , sociology , political science , law , economics , economy
Diagnostic assessment programmes ( DAP s) coordinate multidisciplinary teamwork ( MDT ), and improve wait times and patient satisfaction. No research has established optimal DAP design. This study explored how DAP characteristics influence service delivery. A mixed methods case study of four breast cancer DAP s was conducted including qualitative interviews with health‐care providers and retrospective chart review. Data were integrated using multiple approaches. Twenty‐three providers were interviewed; 411 medical records were reviewed. The number of visits and wait times from referral to diagnosis and consultation were lowest at a one‐stop model. DAP characteristics (rural–remote region, human resources, referral volume, organisation of services, adherence to service delivery targets and one‐stop model) may influence service delivery (number of visits, wait times). MDT , influenced by other DAP characteristics (co‐location of staff, patient navigators, team functioning), may also influence service delivery. While the one‐stop model may be ideal, all sites experienced similar and unique challenges. Further research is needed to understand how to optimise the organisation and delivery of DAP services. Measures reflecting individual, team and patient‐reported outcomes should be used to assess the effectiveness and impact of DAP s in addition to more traditional measures such as wait times.