A136
The development and preliminary application of a measure to describe the quality of cancer MDT meetings
Cath Taylor1, Louise Atkins1, Emma Teasdale1, Alison Richardson2, Amanda Ramirez1
1Institute of Psychiatry, Kings College London, London, UK, 2Florence Nightingale School of Nursing and Midwifery, Kings College London, London, UK
Background and Aim
Cancer multidisciplinary teams are well established in the UK NHS as a core mechanism for improving patient outcomes by bringing together all relevant health professionals to discuss and agree management plans for individual patients. There is evidence of variability in performance of cancer teams from small-scale research studies and national peer review data, but there are no standardised measures by which to assess the quality of multidisciplinary teamworking. We aimed to identify the key characteristics of effective teamworking in cancer multidisciplinary team meetings (MDMs), develop an observational measure of these characteristics, and test the measure by applying it to 10 colorectal cancer MDMs.
Method
Key characteristics of effective teamworking in MDMs, and criteria for rating each characteristic, were derived from literature review, observing MDMs and clinical consensus. This generated 16 characteristics that aggregated to 4 key domains: having an adequate supportive infrastructure; effective clinical decision-making process; good team relations; and opportunities for professional development. We developed a manual containing descriptions of each characteristic, rating scales that describe the range in quality (from insufficient to fully comprehensive), and procedures for applying the measure to videotaped MDMs. The measure was applied to video-recordings of MDMs in 10 colorectal cancer teams.
Results
We found wide diversity in performance between teams across all four domains. There was broad consistency in performance within each team across the four domains. Teams tended to perform better in terms of their supporting infrastructure and team relations. They performed less well in relation to the professional development of team members and clinical decision-making process, particularly lacking consideration of patient-based information and inclusion of relevant team members.
Conclusion
The preliminary application of this measure suggests it may contribute to the measurement of MDT performance. Further testing to confirm the validity and reliability of the measure is required.
