Multidisciplinary team meeting Chairs' attitudes and perceived facilitators, barriers and ideal improvements to meeting functionality: A qualitative study.
hospital
interdisciplinary communication
leadership
multidisciplinary teams
oncology service
teamwork
Journal
Asia-Pacific journal of clinical oncology
ISSN: 1743-7563
Titre abrégé: Asia Pac J Clin Oncol
Pays: Australia
ID NLM: 101241430
Informations de publication
Date de publication:
16 May 2024
16 May 2024
Historique:
revised:
17
04
2024
received:
20
03
2024
accepted:
02
05
2024
medline:
17
5
2024
pubmed:
17
5
2024
entrez:
17
5
2024
Statut:
aheadofprint
Résumé
Oncology care provision by multidisciplinary teams (MDTs) is widely acknowledged as best practice. Formal team meetings, led by chairpersons, coordinate decisions on diagnosis, staging, treatment planning, and review. This study addresses a gap in meeting Chairs' perspectives on factors affecting functionality across the meeting cycle, from pre-meeting patient list triage to post-meeting dissemination of recommendations. Semi-structured interviews were conducted in person with Chairs within two urban geographical regions in New South Wales, Australia as part of a larger project. Though the population of oncology MDT Chairs in Australia is small, the richness and depth of data from nine Chairs were considered to be valuable knowledge in support of extant literature on meeting functionality. An integrated deductive-inductive approach was applied to data analysis. Perceived facilitators, barriers, and ideals relating to pre-meeting, in-meeting, and post-meeting functionality were identified across five pre-determined analytic categories: the team; meeting infrastructure; meeting organization and logistics; patient-centered clinical decision-making, and; team governance. Key barriers included inadequate information technology, limited support staff, and lack of dedicated time for Chair duties. Corresponding facilitators included robust Information Technology infrastructure and support, provision of clinically knowledgeable MDT meeting coordinators, and formal employment recognition of Chairs' responsibilities and skill sets. Chairs across various tumor streams develop workarounds to overcome barriers and ensure quality meeting outcomes. With more robust support they could enhance value by sharing evidence, conducting audits, and engaging in research. The findings highlight the need for healthcare systems to support tumor stream clinical networks by allocating greater resources to prioritize multidisciplinary meetings and cancer care decision-making.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : National Health and Medical Research Council
ID : APP1135048
Informations de copyright
© 2024 The Authors. Asia‐Pacific Journal of Clinical Oncology published by John Wiley & Sons Australia, Ltd.
Références
Winters DA, Soukup T, Sevdalis N, Green JS, Lamb BW. The cancer multidisciplinary team meeting: in need of change? History, challenges and future perspectives. BJU international. 2021;128(3):271‐279.
Australia. Parliament House of Representatives Standing Committee on Community Affairs. Report on the management and treatment of breast cancer in Australia. Australian Government Publishing Service. 1995.
UK Department of Health. The NHS Cancer Plan: A plan for investment, a plan for reform. Department of Health London. 2000.
Lamprell K, Arnolda G, Delaney GP, Liauw W, Braithwaite J. The challenge of putting principles into practice: resource tensions and real‐world constraints in multidisciplinary oncology team meetings. Asia Pac J Clin Oncol. 2019;15(4):199‐207.
Pillay B, Wootten AC, Crowe H, et al. The impact of multidisciplinary team meetings on patient assessment, management and outcomes in oncology settings: a systematic review of the literature. Cancer Treat Rev. 2016;42:56‐72.
Walraven JEW, van der Hel OL, van der Hoeven JJM, Lemmens V, Verhoeven RHA, Desar IME. Factors influencing the quality and functioning of oncological multidisciplinary team meetings: results of a systematic review. BMC Health Serv Res. 2022;22(1):829.
Cancer Australia. All about multidisciplinary care. Cancer Australia Position Statements Website. 2023. Accessed Dec 5, 2023. https://www.canceraustralia.gov.au/clinicians‐hub/multidisciplinary‐care/all‐about‐multidisciplinary‐care
Snyder J, Schultz L, Walbert T. The role of tumor board conferences in neuro‐oncology: a nationwide provider survey. J Neuro‐oncol. 2017;133:1‐7.
Rankin NM, Lai M, Miller D, et al. Cancer multidisciplinary team meetings in practice: results from a multi‐institutional quantitative survey and implications for policy change. Asia Pac J Clin Oncol. 2018;14(1):74‐83.
Ottevanger N, Hilbink M, Weenk M, et al. Oncologic multidisciplinary team meetings: evaluation of quality criteria. J Eval Clin Pract. 2013;19(6):1035‐1043.
Fradgley EA, Booth K, Paul C, Zdenkowski N, Rankin NM. Facilitating high quality cancer care: a qualitative study of Australian Chairpersons’ perspectives on multidisciplinary team meetings. J Multidiscip Healthc. 2021;14(null):3429‐3439.
Nic Giolla Easpaig B, Arnolda G, Tran Y, et al. What is multidisciplinary cancer care like in practice? a protocol for a mixed‐method study to characterise ambulatory oncology services in the Australian public sector. BMJ Open. 2019;9(10):e031179.
Marshall B, Cardon P, Poddar A, Fontenot R. Does Sample size matter in qualitative research? A review of qualitative interviews in is research. J Comput Inform Syst. 2013;54(1):11‐22.
Lamb B, Sevdalis N, Taylor C, Vincent C, Green J. Multidisciplinary team working across different tumour types: analysis of a national survey. Ann Oncol. 2012;23(5):1293‐1300.
Soukup T, Lamb BW, Arora S, Darzi A, Sevdalis N, Green JS. Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature. J Multidiscip Healthc. 2018;11:49‐61.
Taylor C, Ramirez A. Multidisciplinary Team Members Views about MDT Working: Results from a Survey Commissioned by the National Cancer Action Team. London: NHS National Cancer Action Team; 2009.
Braun V, Clarke V. Thematic Analysis: A Practical Guide. Sage Publications Ltd; 2021.
Creswell JW. Qualitative Inquiry and Research Design. 3rd ed. Sage; 2013.
Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi‐disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.
Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res. 2007;42(4):1758‐1772.
Lincoln YS, Guba EG. Naturalistic Inquiry. Sage; 1985.
Tobin GA, Begley CM. Methodological rigour within a qualitative framework. J Adv Nurs. 2004;48(4):388‐396.
National Cancer Action Team. The characteristics of an effective multidisciplinary team (MDT). National Cancer Registration and Analysis Service. 2010.
Prades J, Remue E, van Hoof E, Borras JM. Is it worth reorganising cancer services on the basis of multidisciplinary teams (MDTs)? A systematic review of the objectives and organisation of MDTs and their impact on patient outcomes. Health Policy. 2015;119(4):464‐474.
Nic Giolla Easpaig B, Tran Y, Winata T, et al. The complexities, coordination, culture and capacities that characterise the delivery of oncology services in the common areas of ambulatory settings. BMC Health Serv Res. 2022;22(1):190.
Patkar V, Acosta D, Davidson T, Jones A, Fox J, Keshtgar M. Cancer multidisciplinary team meetings: evidence, challenges, and the role of clinical decision support technology. Int J Breast Cancer. 2011;2011:831605.
Henkel M, Stieltjes B. Structured data acquisition in oncology. Oncology. 2019;98(6):423‐429.
Stone E, Rankin NM, Vinod SK, et al. Clinical impact of data feedback at lung cancer multidisciplinary team meetings: a mixed methods study. Asia Pac J Clin Oncol. 2020;16(1):45‐55.
Bucalon B, Shaw T, Brown K, Kay J. State‐of‐the‐art dashboards on clinical indicator data to support reflection on practice: scoping review. JMIR Med Inform. 2022;10(2):e32695.
Braithwaite J, Churruca K, Ellis LA, et al. Complexity Science in Healthcare. Australian Institute of Health Innovation, Macquarie University; 2017.
Horlait M, De Regge M, Baes S, Eeckloo K, Leys M. Exploring non‐physician care professionals’ roles in cancer multidisciplinary team meetings: a qualitative study. PLoS One. 2022;17(2):e0263611. doi:10.1371/journal.pone.0263611
Tran Y, Lamprell K, Nic Giolla Easpaig B, Arnolda G, Braithwaite J. What information do patients want across their cancer journeys? A network analysis of cancer patients’ information needs. Cancer Med. 2019;8(1):155‐164.
Walraven JEW, van der Hel OL, van der Hoeven JJM, Lemmens VEPP, Verhoeven RHA, Desar IME. Factors influencing the quality and functioning of oncological multidisciplinary team meetings: results of a systematic review. BMC Health Serv Res. 2022;22(1):829.
Hoinville L, Taylor C, Zasada M, Warner R, Pottle E, Green J. Improving the effectiveness of cancer multidisciplinary team meetings: analysis of a national survey of MDT members' opinions about streamlining patient discussions. BMJ Open Qual. 2019;8(2):e000631.
Samarasinghe A, Chan A, Hastrich D, et al. Compliance with multidisciplinary team meeting management recommendations. Asia Pac J Clin Oncol. 2019;15(6):337‐342.