Abstract
Background
Multidisciplinary teams (MDTs) are the standard means of making clinical decisions in surgical oncology. The aim of this study was to explore the views of MDT members regarding contribution to the MDT, representation of patients’ views, and dealing with disagreements in MDT meetings—issues that affect clinical decision making, but have not previously been addressed.
Methods
Responses to open questions from a 2009 national survey of MDT members about effective MDT working in the United Kingdom were analyzed for content. Emergent themes were identified and tabulated, and verbatim quotes were extracted to validate and illustrate themes.
Results
Free-text responses from 1,636 MDT members were analyzed. Key themes were: (1) the importance of nontechnical skills, organizational support, and good relationships between team members for effective teamworking; (2) recording of disagreements (potentially sharing them with patients) and the importance of patient-centered information in relation to team decision making; (3) the central role of clinical nurse specialists as the patient’s advocates, complementing the role of physicians in relation to patient centeredness.
Conclusions
Developing team members’ nontechnical skills and providing organizational support are necessary to help ensure that MDTs are delivering high-quality, patient-centered care. Recording dissent in decision making within the MDT is an important element, which should be defined further. The question of how best to represent the patient in MDT meetings also requires further exploration.
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Acknowledgment
We are grateful to the National Cancer Action Team, who provided access to data from their original survey, which they designed, administered, and analyzed. This research was supported by the National Institute for Health Research through the Imperial Centre for Patient Safety and Service Quality and Whipps Cross University Hospital NHS Trust Urology and R & D Departments.
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The authors report no conflict of interest.
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Lamb, B.W., Taylor, C., Lamb, J.N. et al. Facilitators and Barriers to Teamworking and Patient Centeredness in Multidisciplinary Cancer Teams: Findings of a National Study. Ann Surg Oncol 20, 1408–1416 (2013). https://doi.org/10.1245/s10434-012-2676-9
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DOI: https://doi.org/10.1245/s10434-012-2676-9