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Thomas Asfeldt Outlines Best Practices for Creating an Integrated Team and Communicating

Success for integrated cancer care teams rely on a few things, such as having a champion, commitment, and strong communication, explained Thomas Asfeldt, MBA, RN, director of Outpatient Cancer Services at Sanford Cancer Center.

Success for integrated cancer care teams rely on a few things, such as having a champion, commitment, and strong communication, explained Thomas Asfeldt, MBA, RN, director of Outpatient Cancer Services at Sanford Cancer Center.


What are the best practices that help create integrated care teams in cancer?

The 2 biggest things that I’ve seen, certainly in our program and in talking with others, is: do you have a champion? And are you committed?

When you start an integrated care team—and I’ll just use a tumor site—say you want to start an integrated care team for lung cancer patients, and if you have a physician champion—you really need to have a physician champion for an integrated care team—if you have that champion, it doesn’t have to be the person who has been there the longest or has the longest CV, but it’s a person that really has the passion for that integrated care team. That’s the number 1 thing I think you have to have. That’s a best practice. And that might be someone who has come forward and said, “I want to build this” or “I want to be part of building this; how can we do that?” It might be someone you see that has the personality or the right panache to do that, and you’re showing them the benefits of that for your program, and so together you work to identify that person as the champion.

And then it’s the commitment. It’s the commitment of your entire healthcare team. It’s the commitment of your administration to say, “Yes, this is what we want to be as an integrated healthcare system and delivering care to our patients.” So, it’s having that champion on board and having the commitment of your team, I think, are the 2 most important best practices in building it.

And then it’s jumping in and getting it down. Because it does take some time.

How can integrated care teams prevent a communication breakdown?

Communicate, communicate, communicate. Document, document, document. And whatever the communication looks like, that might mean that you get together and have a morning huddle, if that’s what works best for your system. It might mean that you are providing lunch every day, so everyone gathers informally and talks about what’s going together with your system. The scale of your organization is going to impact how you do that right. If you’re 1 or 2 physicians with 4 or 5 supporting personnel, you can do that differently than if you’re an astronomic organization.

The thing that’s going to be really important for communication is making sure that you’re documenting the recommendations that the integrated team puts together in the EMR [electronic medical record] so that whether you’re the provider that’s taking care of the patient specifically or if the primary care provider who is seeing them on an outpatient basis for their runny nose or their sore back that you also know what the plan of care is for the patient. What was discussed by the care team that’s taking care of their cancer?

So, document, document, document. Communicate, communicate, communicate. And make sure you put it in the record so everyone knows what the plan of care is for the integrated cancer care team.

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