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Recognising Clinical Excellence Evolution: A New Beginning for European Cancer Care

A personal reflection on recognising Clinical Excellence Evolution and why it matters now

The last few months I have spent studying team science and the coordination issues in cancer care. The AI paradox in healthcare. Communication barriers in MDTs. Decision fatigue in tumour boards. Psychological safety gaps. The specialisation paradox.

Today, that changes.

The Pattern I Couldn't Unsee

My journey started in academic research, working with cellular mechanisms and sensory function. Complex systems revealed their elegance through the interfaces between specialised components. Everything connects as one.

Then I moved into medical communications, working with oncology and haematology teams across Europe. I expected to find the same elegant integration I'd witnessed at the molecular level.

Instead, I found brilliance working in parallel.

Outstanding oncologists who knew their fields completely. Exceptional nurses coordinating complex care pathways. Skilled radiologists and pathologists providing critical insights. Each a master of their craft.

Yet coordination remained the limiting factor.

The development of cancer care from diagnosis to treatment has been amazing. The elegance of implementation has been missing.

Not because anyone lacked expertise. Not because teams didn't care. But because we haven't recognized what’s going on. As a result, we haven't created the systematic approaches needed for this natural evolution.

The Evolution Hiding in Plain Sight

Over eight years of working with European cancer care teams, I saw something remarkable. Professionals instinctively understood that their individual excellence wasn't enough; they needed to work together as a team, combining their clinical skills to achieve better results.

This is Clinical Excellence Evolution: the natural professional evolution where clinical expertise instinctively seeks systematic team coordination impact.

It's happening across Europe:

• The oncologist who stays after tumour boards asking "how do we make these discussions more effective?"

• The care coordinator designing better information flows between specialties

• The team leader questioning why brilliant specialists struggle to coordinate

• The mid-career professional recognising their growth path lies in strengthening how teams work together

They're not broken. They're evolving. They recognise something fundamental about modern cancer care: breakthrough therapies demand breakthrough coordination.

But they lack systematic approaches to support this natural progression.

Why European Cancer Care Demands Something Different

In Europe we value evidence-based practice, collaborative decision-making, and professional autonomy. Our cancer care systems emphasise systematic quality frameworks and multidisciplinary integration.

These values create unique coordination dynamics.

European cancer centres face increasing subspecialisation creating knowledge boundaries. Cross-specialty coordination becomes more complex. Time-sensitive decisions carry higher stakes. Emotional intensity affects collaboration. Technology must integrate across disciplines. Patient outcome stakes amplify pressure.

Research across European healthcare systems shows the impact. In nearly one-third of cancer cases, treatment is disrupted by coordination breakdowns and avoidable delays¹. Even four-week treatment delays are consistently associated with increased mortality across major cancers².

The gap between breakthrough treatments and systematic coordination widens daily.

What We've Built: The Six Dimensions Framework

We analyzed over 69 studies from European healthcare systems. This covered more than 4.7 million participants across 800 institutions in over 25 countries. We found six key areas where personal development boosts team effectiveness.

🔬 Clinical Integration

When coordination patterns are clear, individual mastery becomes team effectiveness. Systematic specialist coordination explains 52% of variance in treatment decision quality across 822 cancer case discussions in multidisciplinary team meetings³.

💬 Communication Clarity

Context-aware communication makes information flow smooth and reliable. Structured communication tools improved MDT decision-making from 82% to 93%. Clinicians reported smoother teamwork⁴.

⚡ Decision Efficiency

Decision quality drops after 20 cases. Short breaks fully reverse this decline⁵. Recognising cognitive patterns helps teams protect decision quality under pressure.

🎯 Role Clarity

When roles align clearly, specialists collaborate without overlap or gaps. Role clarity is systematically underdeveloped in MDTs. This limits execution even when discussions are strong⁶.

🛡 Psychological Safety

Teams that create space for honest input make better decisions. 71% of European young oncologists report signs of burnout. Regional rates reach as high as 84%⁷. Psychological safety supports wellbeing and ensures professionals can speak up when it matters most.

🚀 Adaptive Capacity

Teams with strong adaptive processes implement evidence-based practices 3–5 times faster⁸. Adaptive capacity ensures improvements endure and teams advance patient care continuously.

These dimensions don't exist in isolation. They interact, creating compound effects that far outweigh treating each area separately. When you recognise how they connect, small well-timed improvements create something much greater.

The Isolation I Recognised in Myself

For months now, I've been sharing research on team science through LinkedIn. Each post revealed another piece of the coordination puzzle. The isolation that comes with deep expertise. The way mastery can create distance instead of connection.

I recognised this pattern in myself first. Those awkward moments when experimental precision had to become shared knowledge. When discoveries needed human connection, not just data.

Later, working with cancer care experts, I saw it everywhere. Brilliant scientists who understood their research completely but talked past each other. Over crumbles of shared knowledge, views became more important than the matter at hand.

This recognition changed everything. Integration isn't about watering down knowledge; it's about building bridges between separate areas of expertise.

Complex systems need both specialisation and connection. The most beautiful discoveries happen at the interfaces.

Two Explorers, One Pattern

I didn't build this alone.

Corina Richter, trained in organisational leadership and disruptive strategy at Harvard, came from a background of global technology and strategic transformation. In corporate settings, she noticed a familiar pattern: highly skilled specialists who, despite their individual excellence, created fragmentation rather than integration.

When we explored this together, the recognition crystallised. Clinical Excellence Evolution was already happening. Professionals across Europe developing systematic coordination approaches. But there was no shared language, no systematic methodology, no way to recognise and support this natural professional evolution.

What began as parallel observations became Nexus Recognita: the systematic support framework Clinical Excellence Evolution requires.

How It Works: Recognition → Implementation → Connection

We've built three interconnected components:

UnityCheck Assessment (Free)

In 5 minutes, discover your coordination potential across all six dimensions. Receive personalised insights and a MicroShift recommendation you can implement immediately. Plus a 2-week NexusHub community preview.

MicroShifts Implementation

24 evidence-based interventions creating small changes with big impact. Designed specifically for cancer care environments. They respect clinical realities whilst making coordination measurably better.

NexusHub Community (Launching November 2025)

Connect with European professionals implementing Clinical Excellence Evolution. Monthly expert sessions, peer learning, professional networking. Because excellence grows faster when shared.

This isn't training. It's recognition and systematic support for professional evolution already happening naturally.

Why This Timing Matters

Healthcare breakthroughs are accelerating. Coordination cannot lag behind.

Cell and immunotherapies transform treatment planning. Precision medicine demands genetic confirmation and toxicity protocols. Brain metastases that were death sentences five years ago now have targeted therapy options.

Each advance increases coordination complexity. More specialists. Tighter monitoring. Faster alignment requirements.

The gap between what's possible scientifically and what's systematic operationally grows daily.

But here's what fascinates me: small, deliberate coordination improvements create compound effects that transform entire care networks. Tiny steps with systematic approaches change patient outcomes one improvement at a time.

The ESMO Opportunity

We'll be at ESMO Berlin, October 17-21, 2025. Not to sell anything. To learn.

To meet professionals experiencing Clinical Excellence Evolution. To understand coordination challenges across European contexts. To discover how systematic approaches can better support natural professional evolution.

If you're noticing that your clinical skills need better team coordination, I’d love to hear your story.

What coordination patterns keep repeating despite different solutions? What makes the difference between teams that coordinate brilliantly and those that struggle? What systematic approaches have you developed that colleagues have adopted?

What Comes Next

This is the beginning of something larger.

We’re not creating Clinical Excellence Evolution. We’re recognizing it, naming it, and providing support for the professional growth already happening in European cancer care.

Through UnityCheck Assessment, professionals discover their coordination potential. Through MicroShifts, they apply evidence-based improvements that colleagues adopt naturally. Through NexusHub (launching November 2025), they connect with peers creating excellence together.

Individual expertise becomes collective healing power. Isolated brilliance becomes systematic excellence. Natural professional evolution gets the recognition and support it deserves.

An Invitation

If this sounds familiar, whether you've experienced it or seen it in others, start with the UnityCheck Assessment.

Five minutes to discover your coordination potential across six dimensions. A personalised MicroShift recommendation you can implement immediately. Two weeks exploring the NexusHub community preview.

No commitment. No pressure. Recognize the professional growth you're already going through. Use organized strategies to help your natural progress.

Because Clinical Excellence Evolution is happening. This is the systematic support it requires.

Start Your Free UnityCheck Assessment - https://forms.nexusrecognita.com/UnityCheck

Contact us to join the conversatio or meet at ESMO 2025 in Berlin - https://nexusrecognita.com/contact

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References

1. Hesso, L., Renzi, C., Odelli, S., Morani, F., Benitez Majano, S., & Signorelli, C. (2023). Delays in cancer diagnosis: challenges and opportunities in Europe. Journal of Cancer Policy, 39, 100457.

2. Hanna, T. P., King, W. D., Thibodeau, S., Jalink, M., Paulin, G. A., Harvey-Jones, E., ... & Aggarwal, A. (2020). Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ, 371, m4087.

3. Soukup, T., Lamb, B. W., Arora, S., Darzi, A., Sevdalis, N., & Green, J. S. (2020). Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. Journal of Multidisciplinary Healthcare, 11, 49-61.

4. Brown, B., Gude, W. T., Blakeman, T., van der Veer, S. N., Ivers, N., Francis, J. J., ... & Peek, N. (2019). Clinical Performance Feedback Intervention Theory (CP-FIT): a new theory for designing, implementing, and evaluating feedback in health care based on a systematic review and meta-synthesis of qualitative research. Implementation Science, 14(1), 1-25.

5. Soukup, T., Gandamihardja, T. A., McInerney, S., Green, J. S., & Sevdalis, N. (2019). Do multidisciplinary cancer care teams suffer decision-making fatigue: an observational, longitudinal team improvement study. BMJ Open, 9(2), e027303.

6. Horlait, M., Baes, S., Dhaene, S., Van Belle, S., & Leys, M. (2019). How multidisciplinary are multidisciplinary team meetings in cancer care? An observational study in oncology departments in Flanders, Belgium. Journal of Multidisciplinary Healthcare, 12, 159-168.

7. Banerjee, S., Califano, R., Corral, J., de Azambuja, E., De Mattos-Arruda, L., Guarneri, V., ... & Tabernero, J. (2017). Professional burnout in European young oncologists: results of the European Society for Medical Oncology (ESMO) Young Oncologists Committee Burnout Survey. Annals of Oncology, 28(7), 1590-1596.

8. Nilsen, P., & Bernhardsson, S. (2019). Context matters in implementation science: a scoping review of determinant frameworks that describe contextual determinants for implementation outcomes. BMC Health Services Research, 19(1), 1-21.

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8 October, 2025

Istvan Borbiro, PhD
Co-Founder, Nexus Recognita