Quality assessment of a multidisciplinary tumour meeting for patients with head and neck cancer

Abstract

Head and neck oncology MDT meetings are held in our region to establish a correct diagnosis and an appropriate treatment plan for each reviewed patient. The quality of these MDT meetings was assessed based on the following factors: How often can a diagnosis, a TNM-classification and a treatment plan be successfully established from the workup presented at the patient's first MDT meeting? And what are the reasons for failure? Further, how often are the TNM-classification altered at treatment start? All patients (n=329) presented at MDT meetings during one year were included prospectively and data were collected in a protocol. As telemedicine recently was introduced to reduce travel, any eventual impact on quality on decisions with regard to telemedicine were also studied. A diagnosis and a treatment plan could be established for 236 (73%) of 324 patients at the first MDT meeting. TNM classification was revised in four patients (1.4%) before treatment. In conclusion, the validity of decisions made at the MDT meeting is satisfactory, but improvements regarding the quality of workups are possible. The mode of presentation of patients at the MDT meeting was not decisive for the quality of decisions regarding diagnosis and treatment plans.

Multidisciplinary Cancer Team Meeting Structure and Treatment Decisions: A Prospective Correlational Study

“…Our finding that a decision could be reached in 85 % of cases is in line with previous findings from studies performed in France and Sweden. 19,20 The authors of a previous study also found that failure of decision-making was related to inadequate information on imaging, staging, histology, and comorbidities, which is consistent with our own analysis. 20 The findings of this study have several implications for MDT working.…”

“…7 Existing studies have suggested that the ability of a MDT to reach a treatment decision for any given case, along with measures of the quality of information and teamwork, can be useful markers of team performance. 19,20 To date, however, no studies have prospectively and scientifically assessed the effect of factors, such as the quality of available information, teamworking, or timing of meetings, on the ability of the MDT to make clinical decisions.…”

“Do no harm”: Fortifying MDT collaboration in changing technological times

“…The reconfiguration of cancer services following recommendation for MDT working [4] is attributed, at least in part, to an increase in staff stress [23]. Patients clearly benefit from being treated by a surgeon with a high workload [24], but the impact of the stress and emotional exhaustion identified in MDTs [25] has yet to be measured, and [26] suggests that quality assurance measures are needed. While several have sought to identify the factors that help MDTMs work better [27][28][29] a general formula for success remains elusive.…”

Developing and Testing TEAM (Team Evaluation and Assessment Measure), a Self-assessment Tool to Improve Cancer Multidisciplinary Teamwork

“…12,13 Failure of the team to consider all relevant information may lead to poor decisions, or to decisions which are not implemented as they are unacceptable to patients or clinically inappropriate. [14][15][16][17] Nonimplementation of MDT meeting recommendations can have both clinical and financial consequences if further discussion is required and treatment is delayed.…”