Improving The Effectiveness Of Cancer Multidisciplinary Team Meetings: Analysis Of A National Survey Of Mdt Members' Opinions About Streamlining Patient Discussions

Linda Hoinville,Cath Taylor,Magda Zasada,Ross Warner, Emma Pottle,James Green

BMJ OPEN QUALITY(2019)

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摘要
BackgroundCancer is diagnosed and managed by multidisciplinary teams (MDTs) in the UK and worldwide, these teams meet regularly in MDT meetings (MDMs) to discuss individual patient treatment options. Rising cancer incidence and increasing case complexity have increased pressure on MDMs. Streamlining discussions has been suggested as a way to enhance efficiency and to ensure high-quality discussion of complex cases.MethodsSecondary analysis of quantitative and qualitative data from a national survey of 1220 MDT members regarding their views about streamlining MDM discussions.ResultsThe majority of participants agreed that streamlining discussions may be beneficial although variable interpretations of 'streamlining' were apparent. Agreement levels varied significantly by tumour type and occupational group. The main reason for opposing streamlining were concerns about the possible impact on the quality and safety of patient care. Participants suggested a range of alternative approaches for improving efficiency in MDMs in addition to the use of treatment protocols and pre-MDT meetings.ConclusionsThis work complements previous analyses in supporting the development of tumour-specific guidance for streamlining MDM discussions considering a range of approaches. The information provided about the variation in opinions between MDT for different tumour types will inform the development of these guidelines. The evidence for variation in opinions between those in different occupational groups and the reasons underlying these opinions will facilitate their implementation. The impact of any changes in MDM practices on the quality and safety of patient care requires evaluation.
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关键词
cancer, streamlining, teamwork, effectiveness, multidisciplinary
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