Improving the effectiveness of cancer multidisciplinary team meetings: analysis of a national survey of MDT members' opinions about streamlining patient discussions

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.

Keywords: cancer; effectiveness; multidisciplinary; streamlining; teamwork.

Figure 1

Variation in opinions about the benefits and methods used for streamlining between MDT for different types of tumour and occupational groups. (A) Agreement that the selected MDT would benefit from some form of streamlining in MDT for different tumour types. (B) Agreement that some patients in the selected MDT should be discussed by a smaller team, rather than by the full MDT in MDT for different tumour types. (C) Agreement that some patients in the selected MDT should be placed on protocolised treatment pathways and not discussed at the meeting in MDT for different tumour types. (D) Agreement that the selected MDT would benefit from some form of streamlining in different occupational groups. (E) Agreement that some patients in the selected MDT should be discussed by a smaller team, rather than by the full MDT in different occupational groups. (F) Agreement that some patients in the selected MDT should be placed on protocolised treatment pathways and not discussed at the meeting in different occupational groups. AHP, allied health professional; Child/Young, children and young people; CNS, clinical nurse specialist; Co-ord/Admin, Co-ordinator/administrator; GI, gastrointestinal; MDT, multidisciplinary team; other MS, other medical speciality; other NR, other nursing role; Unk, unknown.