Under the auspices of the Ministry of Public Health, the Higher Institute of Public Health (ISSP) at Saint Joseph University of Beirut (USJ) organized a conference and a panel discussion on “Interprofessional Collaboration in Cancer Treatment” at the Medical Sciences Campus.

In her address, ISSP Director Prof. Michèle Kosremelli Asmar highlighted her 1993 introduction to interprofessional collaboration during her hospital internship, noting the significant resistance at that time. Since then, it has become a crucial skill mandated by accreditation boards for all healthcare professionals. Emphasizing the imperative for collaboration in cancer care, Prof. Asmar stressed its collective nature involving diverse healthcare professionals throughout the patient’s care continuum. It transcends organizational boundaries, fostering a culture of communication, respect, and empathy, vital for comprehensive, individualized cancer care.

Prof. Asmar asserted that collaboration is not just a concept but a lifeline for those battling cancer. It creates an ecosystem where each healthcare professional contributes uniquely to holistic patient well-being. The call for consistent evolution, innovation, and bridging interdisciplinary gaps is crucial. Leveraging technology, research advancements, and collective expertise addresses disparities, enhances survival programs, and advances preventive strategies, necessitating a new mindset.

“Today’s conference catalyzes action. It presents an opportunity for us to establish fresh partnerships, exchange ideas, and commit to a shared vision: a future where every individual affected by cancer receives compassionate care of the highest quality,” she concludes.

Prof. Elie Nemer, Dean of the Faculty of Medicine (FM) at USJ, emphasized the need for unity in healthcare, stating, “Just as we proclaimed ‘All for the Fatherland’ on Independence Day, we must now declare ‘All together for the patient.’ Barriers between health professionals should not exist, as long as there is agreement on the shared goal, which is the patient’s best interest. Cooperation, viewed not as a sacrifice but as a benefit and duty, is essential. Collaborations, such as between the FM and the ISSP, elevate public health approaches within the Faculty.”

Prof. Nemer highlighted the successful implementation of the National Cancer Plan and underscored the significance of fostering cooperation within this framework, extending to the FM and other USJ Institutes of Health.

Dr. Arafat Tfayli, representing the Minister of Public Health, Dr. Firas Abiad, underscored the paramount importance of collaboration in cancer care. He contended, “Optimal care is unattainable without collaboration, despite guidelines, observing variations in patient treatment. Primary collaboration should exist among oncologists, followed by healthcare professionals within the same institution. Effectively treating patients requires a reliable pathologist, trustworthy surgeon, and support from social workers and psychologists. Collaboration must extend to physiotherapists and nurses.” Dr. Tfayli emphasizes the pivotal role of a tumor committee involving all specialists as the cornerstone of institutional collaboration. The third tier focuses on institutions seeking common national plans, with the Ministry of Health playing a crucial role at the national stage.

During the first session, representatives from six Beirut teaching hospitals shared their experiences and strategies for interprofessional collaboration in cancer care. Notable presentations included the success of the palliative care department at Saint George Hospital in Beirut, shared by Dr. Dany Gholam and Ms. Najibeh Saad. LAU-Rizk Hospital’s experience was presented by Dr. Hady Ghanem, Ms. Léa Baaklini, and Ms. Dina Motran. Céline Abou Karam, representing AUB-MC hospital, presented the Nayef Basile Institute’s experience. Hôtel-Dieu de France Hospital was represented by Dr. Joseph Kattan, Ms. Marie-Claire Mouhawej, and Ms. Jacqueline Awad. Dr. Maroun Sadek shared insights from Lebanese Geitaoui Hospital, and Dr. Ahmad Ibrahim represented Makassed Hospital.

Participants unanimously acknowledged the importance of interprofessional collaboration, considering it essential for fostering communication and coordination among various specialties. This collaborative approach proved instrumental in meeting patients’ needs, optimizing their care pathways, and enhancing their quality of life.

Survey findings revealed the presence of interprofessional collaboration, albeit not consistently applied across all aspects. Notably, significant strides were observed in palliative care, with active involvement from non-governmental organizations. Multidisciplinary teams were present in all hospitals, albeit with variations in membership. Some hospitals had developed specialized programs and supported research projects.

The hospitals collectively highlighted the need to address barriers hindering collaboration in cancer care. These barriers manifest at both institutional and national levels, encompassing financial constraints, expertise and education, communication challenges, access to supportive care, and legal impediments, particularly the absence of unified national guidelines.

However, all hospitals shared insights into potential solutions for enhancing the implementation of interprofessional collaboration. These solutions encompass improved communication within the care team, personalized care, enhanced prevention and early intervention, the digitization of communication tools, a deeper understanding of each care team member’s roles, and active involvement at academic and professional levels through colleges and unions.

Breast cancer survivor Nada Basile shared her treatment experience, emphasizing the critical need for better communication between patients and doctors, as well as among medical professionals. She highlighted delays or the absence of referrals to supportive care, underscoring the vital role of prevention and early intervention in enhancing both the patient’s quality of life and the overall cost of care.

The second session, conducted as a panel discussion and moderated by Ms. Rola Mouawad with the participation of Prof. Michèle Kosremelli Asmar, featured Dr. Arafat Tfayli, Prof. Elie M. Sleiman Haroun (President of the Hospitals Syndicate), Prof. Roger Khater (President of the Lebanese Oncology Society), Dr. Elie Dahdah (representing the Order of Physiotherapists), Ms. Farah Dimachkieh (representing the Order of Nurses), Dr. Krystel Oueijan (representing the Order of Nutritionists), and Dr. Fatima Chehouri (President of the Syndicate of Occupational Therapists). The participants engaged in discussions about the potential application of interprofessional collaboration.

Dr. Tfayli underscored the significance of enhancing prevention, emphasizing the need for awareness campaigns, third-party coverage, and the introduction of a ‘patient navigator’ before implementing interprofessional collaboration. Dr. Khater and Mr. Haroun voiced concerns about drug coverage.

At the academic level, Prof. Nemer highlighted the communication gaps within the multidisciplinary cancer care team, emphasizing the importance of initiating such communication at the university level. Representatives from nursing, physiotherapy, occupational therapy, and dietetics professions elucidated their respective roles within the cancer care team.

The discussion also underscored the imperative for a comprehensive reassessment of the healthcare system to implement changes at all levels. Delving into the financial coverage of medical and support care, the conversation illuminated the impact of limited resources within the Ministry of Health’s infrastructure on the effective execution of the national cancer plan.

Key points emerged from the speakers, aimed at fortifying inter-professional collaboration, encompassing:

- Emphasizing the importance of prevention and early intervention;

- Prioritizing patient education and expanding support care coverage;

- Developing national procedural guidelines applicable across all hospitals and enhancing access to medicines;

- Recognizing the role of universities in training healthcare providers, organizing workshops on interprofessionality in hospitals, and implementing policies and procedures;

- Fostering an understanding of each member’s role within the multidisciplinary team;

- Acknowledging supportive care as a necessity;

- Integrating interprofessional collaboration into the accreditation of centers of excellence and activating the Higher Health Council;

- Conducting a Ministry of Finance study on the cost of healthcare;

- Enhancing the role of NGOs in inter-professional collaboration;

- Facilitating the sharing of experiences from Class A hospitals in Beirut with establishments in different regions.

The panel discussion concluded with several recommendations:

- Advocating for the reform of academic programs at the university level;
-Each union, order, and hospital participating in the conference to assess its current situation regarding the strategies adopted, obstacles faced, and facilitators of interprofessional collaboration in cancer care in Lebanon;

- Compiling the data collected by universities, colleges, and hospitals into a joint recommendations document;

- Presenting this document to the Ministry of Public Health for adjustment and widespread implementation in the Lebanese field upon adoption by the Ministry.

Read also:« La collaboration interprofessionnelle dans le traitement du cancer » à l’ISSP

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