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World J Clin Cases. Dec 16, 2014; 2(12): 757-768
Published online Dec 16, 2014. doi: 10.12998/wjcc.v2.i12.757
Relational coordination and healthcare management in lung cancer
José Antonio Vinagre Romero, Juan Del Llano Señarís, Carmen De Pablos Heredero, Mark Nuijten
José Antonio Vinagre Romero, Clinical Management, Business Organization, Entrepreneurship, Health Administration, Business Organization, Universidad Rey Juan Carlos, Respiratory Unit at La Paz University Hospital, 28046 Madrid, Spain
Juan Del Llano Señarís, Community Health, Gaspar Casal Foundation, Universidad Pompeu Fabra-CRES, 28006 Madrid, Spain
Carmen De Pablos Heredero, Economics, Rey Juan Carlos University, School of Social Sciences, Doctoral Program in Business Organization and Entrepreneurship, 28032 Madrid, Spain
Mark Nuijten, Rotterdam School of Management, Erasmus University, University of Maastricht and the University of Groningen, 3062 PA, Rotterdam, The Netherlands
Author contributions: All authors contributed to this paper.
Correspondence to: José Antonio Vinagre Romero, RN, MSc in Clinical Management, MSc in Business Organization, MSc in Entrepreneurship, Master of Health Administration, PhD Candidate in Business Organization, Universidad Rey Juan Carlos, Respiratory Unit at La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain. joseantonio.vinagre@salud.madrid.org
Telephone: +34-61-6860921
Received: August 12, 2014
Revised: October 22, 2014
Accepted: October 31, 2014
Published online: December 16, 2014
Processing time: 128 Days and 9.2 Hours
Abstract

In the current socio-economic scenario characterized by a growing shortage of resources and progressive budget constraints, the need to better coordinate processes in health institutions appears as a relevant aspect to ensure the future sustainability of system. In this sense, Relational Coordination (RC) provides a valuable opportunity for the reconfiguration of clinical guidelines concerning isolated single-level considerations. In this research the RC model has been applied to explain best results in the process of diagnosing and offering clinical treatments for lung cancer. Lung cancer presents the higher rates of tumor’s mortality worldwide. Through unstructured and informal interviews with clinicians at both levels (Primary/Specialist Care), a diagnosis of the situation in relation to joint management of lung cancer is provided. Solutions of continuity in terms of coordination are explained due to the observation of lack of effective knowledge transfer between the two levels. It is this disconnection which justifies the introduction of a modified model of RC for the study and implementation of transfer relations between the knowledge holders, in order to structure consolidated and cooperative evidence-based models that lead to a substantial shortening in the response times with a marked outcomes improvement. To our knowledge, the application of this model to a Public Health problem bringing together both levels of care, hasn’t been made till now.

Keywords: Relational Coordination; Lung cancer; Clinical pathway; Dialogic practices; High performance work systems; Healthcare performance

Core tip: Innovative managerial frameworks have to be put into practice when treating severe diseases. Relational Coordination makes possible to enhance inter-level knowledge networks to obtain better outcomes from the perspective of the National Health System and the patients. Through systematic revision, it has been checked that only in the fields of Endocrinology and Psychiatry have these frameworks been applied. This model tries to establish a coordinative solution within the field of Oncology, implementing the Theory of Relational Coordination as a tool to get optimal results in lung cancer.