Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study

Abstract

BackgroundThe prevalence of multidisciplinary teams (MDT) for the delivery of cancer care is increasing globally. Evidence exists of benefits to patients and healthcare professionals. However, MDT working is time and resource intensive. This study aims to explore members’ views on existing practices of urology MDT working, and to identify potential interventions for improving the efficiency and productivity of the MDT meeting.MethodsMembers of urology MDTs across the UK were purposively recruited to participate in an online survey. Survey items included questions about the utility and efficiency of MDT meetings, and strategies for improving the efficiency of MDT meetings: treating cases by protocol, prioritising cases, and splitting the MDT into subspeciality meetings.Results173 MDT members participated (Oncologists n = 77, Cancer Nurses n = 54, Urologists n = 30, other specialities n = 12). 68% of respondents reported that attending the MDT meeting improves efficiency in care through improved clinical decisions, planning investigations, helping when discussing plans with patients, speciality referrals, documentation/patient records. Participants agreed that some cases including low risk, non-muscle invasive bladder cancer and localised, low-grade prostate cancer could be managed by pre-agreed pathways, without full MDT review. There was a consensus that cases at the MDT meeting could be prioritised by complexity, tumour type, or the availability of MDT members. Splitting the MDT meeting was unpopular: potential disadvantages included loss of efficiency, loss of team approach, unavailability of members and increased administrative work.ConclusionKey urology MDT members find the MDT meeting useful. Improvements in efficiency and effectiveness may be possible by prioritising cases or managing some low-risk cases according to previously agreed protocols. Further research is needed to test the effectiveness of such strategies on MDT meetings, cancer care pathways and patient outcomes in clinical practice.

ASPEN Safe Practices for Enteral Nutrition Therapy

“…Whenever possible, additional communication between the recommending clinician and the prescribing physician is encouraged. Open dialogue between 2 or more people improves communication and information sharing in the context of healthcare 39 . ‐ 44 In‐person discussion is considered more effective than other methods of communication (such as telephone calls, e‐mail, or text messaging) to reinforce the assessment and recommendations provided in the EHR (or paper chart if still in use).…”

“…‐ 44 In‐person discussion is considered more effective than other methods of communication (such as telephone calls, e‐mail, or text messaging) to reinforce the assessment and recommendations provided in the EHR (or paper chart if still in use). In the inpatient setting, in‐person communication can occur during interdisciplinary patient care rounds, but follow‐up written documentation is important 39 . ‐ 44 …”

Patient experience and quality of urologic cancer surgery in US hospitals

“…As demonstrated in the current study, hospital inefficiency and nursing‐sensitive adverse events may be amenable to approaches that leverage the patient experience as a process measure. For cancer‐directed surgeries, the use of care teams that heavily integrate nursing may offer immediate dividends given established data in surgery and oncology demonstrating improvements in communication, safety culture, and patient satisfaction when implementing an interdisciplinary team‐based approach . When used in this manner, the CMS Value‐Based Purchasing program and similar initiatives may boost the patient experience and outcomes through a common pathway.…”

Is the co-location of GPs in primary care centres associated with a higher patient satisfaction? Evidence from a population survey in Italy

“…This is particularly important for elderly patients [11] and in general for people with chronic conditions [12, 13], as well as for mental disorders [14] and cancer [15–17], or in acute conditions such as stroke rehabilitation [18]. Because of their complex needs, all these patients use health services frequently, and interact frequently with social and health professionals and in particular with different primary and secondary care providers, with a high risk of experiencing fragmentation in their care pathway [19].…”