Barbara DeVivo
Westmount University, USA
Biography:
Abstract:
Hospital Tumor Boards (TB) bring together multiple specialists in an effort to determine an optimal patient treatment
program. However, previous research on Tumor Boards suggests that multidisciplinary TBs do not necessarily
improve patient care, quality or survival. Drawing on insights from organizational theory and behavior, this research aimed
to understand why Tumor Boards often fail to live up to their potential. The study used ethnographic methods including
participant observation over three years of 44 Tumor Boards and 18 unstructured interviews at seven United States and
United Kingdom research hospitals. The study found that several factors related to endogenous and exogenous sources of
uncertainty in TBs contributed to sub-optimal treatment programs. Specifically, the study found that while the objective of
TB meetings was to reach optimal patient treatment decisions, the decision-making processes tended to be obstructed by (a)
hierarchical and nonhierarchical structures within the medical profession, (exogenous uncertainty) and (b) level of situational
complexity of patient cases (endogenous uncertainty). Together, these factors influenced and obstructed the “sensemaking” of
TB members. Future research should focus on better understanding how internal management policies derived from insights
from organizational theory can better facilitate the decision-making process in TB structures in highly complex patient cases.