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Improving the effectiveness of cancer multidisciplinary team meetings: analysis of a national survey of MDT members’ opinions about streamlining patient discussions
  1. Linda Hoinville1,
  2. Cath Taylor1,
  3. Magda Zasada1,
  4. Ross Warner2,
  5. Emma Pottle3,
  6. James Green4
  1. 1School of Health Sciences, University of Surrey, Guildford, UK
  2. 2Department of Urology, Leicester General Hospital, Leicester, UK
  3. 3GKT School of Medical Education, King's College London School of Medical Education, London, UK
  4. 4Whipps Cross University Hospital, Barts Health NHS Trust, London, UK
  1. Correspondence to Dr Linda Hoinville; l.hoinville{at}surrey.ac.uk

Abstract

Background Cancer 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.

Methods Secondary analysis of quantitative and qualitative data from a national survey of 1220 MDT members regarding their views about streamlining MDM discussions.

Results The 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.

Conclusions This 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.

  • cancer
  • streamlining
  • teamwork
  • effectiveness
  • multidisciplinary

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors LH planned the analysis, led the quantitative analysis and drafted the manuscript; MZ led the qualitative analysis; RW and EP carried out initial data analysis and interpretation; CT and JG provided guidance on the objectives and interpretation; and all the authors reviewed the manuscript and approved the final version.

  • Funding This was a secondary analysis of the data provided by CRUK, which was not supported by any specific project grant. EP’s contribution was funded by a King's Undergraduate Research Fellowship.

  • Competing interests None of the authors has conflict of interest though CT and JG declare that both were members of the steering group that guided the development of the survey on which this manuscript is based, and both have previously received funding from NHS England for the development of a team training/feedback system for cancer MDTs through Green Cross Medical Ltd.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

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