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Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Benefits, barriers and opinions on multidisciplinary team meetings: a survey in Swedish cancer care

Authors: Linn Rosell, Nathalie Alexandersson, Oskar Hagberg, Mef Nilbert

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

Case review and discussion at multidisciplinary team meetings (MDTMs) have evolved into standard practice in cancer care with the aim to provide evidence-based treatment recommendations. As a basis for work to optimize the MDTMs, we investigated participants’ views on the meeting function, including perceived benefits and barriers.

Methods

In a cross-sectional study design, 244 health professionals from south Sweden rated MDTM meeting structure and function, benefits from these meetings and barriers to reach a treatment recommendation.

Results

The top-ranked advantages from MDTMs were support for patient management and competence development. Low ratings applied to monitoring patients for clinical trial inclusion and structured work to improve the MDTM. Nurses and cancer care coordinators did less often than physicians report involvement in the case discussions. Major benefits from MDTM were reported to be more accurate treatment recommendations, multidisciplinary evaluation and adherence to clinical guidelines. Major barriers to a joint treatment recommendation were reported to be need for supplementary investigations and insufficient pathology reports.

Conclusions

Health professionals’ report multiple benefits from MDTMs, but also define areas for improvement, e.g. access to complete information and clarified roles for the different health professions. The emerging picture suggests that structures for regular MDTM evaluations and increased focus on patient-related perspectives should be developed and implemented.
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Literature
1.
go back to reference El Saghir NS, Keating NL, Carlson RW, Khoury KE, Fallowfield L. Tumor boards: optimizing the structure and improving efficiency of multidisciplinary management of patients with cancer worldwide. Am Soc Clin Oncol Educ Book. 2014;34:e461–6.CrossRef El Saghir NS, Keating NL, Carlson RW, Khoury KE, Fallowfield L. Tumor boards: optimizing the structure and improving efficiency of multidisciplinary management of patients with cancer worldwide. Am Soc Clin Oncol Educ Book. 2014;34:e461–6.CrossRef
2.
go back to reference Pillay B, Wootten AC, Crowe H, Corcoran N, Tran B, Bowden P, 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.CrossRefPubMed Pillay B, Wootten AC, Crowe H, Corcoran N, Tran B, Bowden P, 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.CrossRefPubMed
3.
go back to reference Brannstrom F, Bjerregaard JK, Winbladh A, Nilbert M, Revhaug A, Wagenius G, et al. Multidisciplinary team conferences promote treatment according to guidelines in rectal cancer. Acta Oncol. 2015;54(4):447–53.CrossRefPubMed Brannstrom F, Bjerregaard JK, Winbladh A, Nilbert M, Revhaug A, Wagenius G, et al. Multidisciplinary team conferences promote treatment according to guidelines in rectal cancer. Acta Oncol. 2015;54(4):447–53.CrossRefPubMed
4.
go back to reference 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 (Amsterdam, Netherlands). 2015;119(4):464–74.CrossRef 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 (Amsterdam, Netherlands). 2015;119(4):464–74.CrossRef
5.
go back to reference Freeman RK, Ascioti AJ, Dake M, Mahidhara RS. The effects of a multidisciplinary care conference on the quality and cost of Care for Lung Cancer Patients. Ann Thorac Surg. 2015;100(5):1834–8. discussion 8CrossRefPubMed Freeman RK, Ascioti AJ, Dake M, Mahidhara RS. The effects of a multidisciplinary care conference on the quality and cost of Care for Lung Cancer Patients. Ann Thorac Surg. 2015;100(5):1834–8. discussion 8CrossRefPubMed
6.
go back to reference Pan CC, Kung PT, Wang YH, Chang YC, Wang ST, Tsai WC. Effects of multidisciplinary team care on the survival of patients with different stages of non-small cell lung cancer: a national cohort study. PLoS One. 2015;10(5):e0126547.CrossRefPubMedPubMedCentral Pan CC, Kung PT, Wang YH, Chang YC, Wang ST, Tsai WC. Effects of multidisciplinary team care on the survival of patients with different stages of non-small cell lung cancer: a national cohort study. PLoS One. 2015;10(5):e0126547.CrossRefPubMedPubMedCentral
7.
go back to reference Munro A, Brown M, Niblock P, Steele R, Carey F. Do multidisciplinary team (MDT) processes influence survival in patients with colorectal cancer? A population-based experience. BMC Cancer. 2015;15:686.CrossRefPubMedPubMedCentral Munro A, Brown M, Niblock P, Steele R, Carey F. Do multidisciplinary team (MDT) processes influence survival in patients with colorectal cancer? A population-based experience. BMC Cancer. 2015;15:686.CrossRefPubMedPubMedCentral
8.
go back to reference Keating NL, Landrum MB, Lamont EB, Bozeman SR, Shulman LN, McNeil BJ. Tumor boards and the quality of cancer care. J Natl Cancer Inst. 2013;105(2):113–21.CrossRefPubMedPubMedCentral Keating NL, Landrum MB, Lamont EB, Bozeman SR, Shulman LN, McNeil BJ. Tumor boards and the quality of cancer care. J Natl Cancer Inst. 2013;105(2):113–21.CrossRefPubMedPubMedCentral
9.
go back to reference Raine R, Wallace I, Nic a’ Bhaird C, Xanthopoulou P, Lanceley A, Clarke A, et al. Improving the effectiveness of multidisciplinary team meetings for patients with chronic diseases: a prospective observational study. Health Serv Del Res. 2014;2(37):1–72.CrossRef Raine R, Wallace I, Nic a’ Bhaird C, Xanthopoulou P, Lanceley A, Clarke A, et al. Improving the effectiveness of multidisciplinary team meetings for patients with chronic diseases: a prospective observational study. Health Serv Del Res. 2014;2(37):1–72.CrossRef
10.
go back to reference Lamb B, Green JS, Vincent C, Sevdalis N. Decision making in surgical oncology. Surg Oncol. 2011;20(3):163–8.CrossRefPubMed Lamb B, Green JS, Vincent C, Sevdalis N. Decision making in surgical oncology. Surg Oncol. 2011;20(3):163–8.CrossRefPubMed
11.
12.
go back to reference Alexandersson N, Rosell L, Wihl J, Ohlsson B, Steen Carlsson K, Nilbert M. Determinants of variable resource use for multidisciplinary team meetings in cancer care. Acta Oncol. 2017;3:1–6.CrossRef Alexandersson N, Rosell L, Wihl J, Ohlsson B, Steen Carlsson K, Nilbert M. Determinants of variable resource use for multidisciplinary team meetings in cancer care. Acta Oncol. 2017;3:1–6.CrossRef
13.
go back to reference Lamb BW, Jalil RT, Sevdalis N, Vincent C, Green JS. Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study. BMC Health Serv Res. 2014;14:377.CrossRefPubMedPubMedCentral Lamb BW, Jalil RT, Sevdalis N, Vincent C, Green JS. Strategies to improve the efficiency and utility of multidisciplinary team meetings in urology cancer care: a survey study. BMC Health Serv Res. 2014;14:377.CrossRefPubMedPubMedCentral
15.
go back to reference Lamb BW, Taylor C, Lamb JN, Strickland SL, Vincent C, Green JS, et al. Facilitators and barriers to teamworking and patient centeredness in multidisciplinary cancer teams: findings of a national study. Ann Surg Oncol. 2013;20(5):1408–16.CrossRefPubMed Lamb BW, Taylor C, Lamb JN, Strickland SL, Vincent C, Green JS, et al. Facilitators and barriers to teamworking and patient centeredness in multidisciplinary cancer teams: findings of a national study. Ann Surg Oncol. 2013;20(5):1408–16.CrossRefPubMed
16.
go back to reference Team RC. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2015. Team RC. R: a language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2015.
17.
go back to reference Lamb BW, Brown KF, Nagpal K, Vincent C, Green JS, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18(8):2116–25.CrossRefPubMed Lamb BW, Brown KF, Nagpal K, Vincent C, Green JS, Sevdalis N. Quality of care management decisions by multidisciplinary cancer teams: a systematic review. Ann Surg Oncol. 2011;18(8):2116–25.CrossRefPubMed
18.
go back to reference Jalil R, Lamb B, Russ S, Sevdalis N, Green JS. The cancer multi-disciplinary team from the coordinators’ perspective: results from a national survey in the UK. BMC Health Serv Res. 2012;12:457.CrossRefPubMedPubMedCentral Jalil R, Lamb B, Russ S, Sevdalis N, Green JS. The cancer multi-disciplinary team from the coordinators’ perspective: results from a national survey in the UK. BMC Health Serv Res. 2012;12:457.CrossRefPubMedPubMedCentral
19.
go back to reference Punshon G, Endacott R, Aslett P, Brocksom J, Fleure L, Howdle F, et al. The experiences of specialist nurses working within the uro-oncology multidisciplinary team in the United Kingdom. Clinical Nurse Spec. 2017;31(4):210–8.CrossRef Punshon G, Endacott R, Aslett P, Brocksom J, Fleure L, Howdle F, et al. The experiences of specialist nurses working within the uro-oncology multidisciplinary team in the United Kingdom. Clinical Nurse Spec. 2017;31(4):210–8.CrossRef
20.
21.
go back to reference Lamb BW, Sevdalis N, Arora S, Pinto A, Vincent C, Green JS. Teamwork and team decision-making at multidisciplinary cancer conferences: barriers, facilitators, and opportunities for improvement. World J Surg. 2011;35(9):1970–6.CrossRefPubMed Lamb BW, Sevdalis N, Arora S, Pinto A, Vincent C, Green JS. Teamwork and team decision-making at multidisciplinary cancer conferences: barriers, facilitators, and opportunities for improvement. World J Surg. 2011;35(9):1970–6.CrossRefPubMed
22.
go back to reference Restivo L, Apostolidis T, Bouhnik A-D, Garciaz S, Aurran T, Julian-Reynier C. Patients’ non-medical characteristics contribute to collective medical decision-making at multidisciplinary oncological team meetings. PLoS One. 2016;11(5):e0154969.CrossRefPubMedPubMedCentral Restivo L, Apostolidis T, Bouhnik A-D, Garciaz S, Aurran T, Julian-Reynier C. Patients’ non-medical characteristics contribute to collective medical decision-making at multidisciplinary oncological team meetings. PLoS One. 2016;11(5):e0154969.CrossRefPubMedPubMedCentral
23.
go back to reference Hamilton WD, Heaven B, Thomson GR, Wilson AJ, Exley C. Multidisciplinary team decision-making in cancer and the absent patient: a qualitative study. BMJ Journals. 2016;6:e012559. Hamilton WD, Heaven B, Thomson GR, Wilson AJ, Exley C. Multidisciplinary team decision-making in cancer and the absent patient: a qualitative study. BMJ Journals. 2016;6:e012559.
24.
go back to reference Rao K, Manya K, Azad A, Lawrentschuk N, Bolton D, Davis ID, et al. Uro-oncology multidisciplinary meetings at an Australian tertiary referral Centre--impact on clinical decision-making and implications for patient inclusion. BJU Int. 2014;114(Suppl 1):50–4.CrossRefPubMed Rao K, Manya K, Azad A, Lawrentschuk N, Bolton D, Davis ID, et al. Uro-oncology multidisciplinary meetings at an Australian tertiary referral Centre--impact on clinical decision-making and implications for patient inclusion. BJU Int. 2014;114(Suppl 1):50–4.CrossRefPubMed
25.
go back to reference Rajan S, Foreman J, Wallis MG, Caldas C, Britton P. Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended? Br J Cancer. 2013;108(12):2442–7.CrossRefPubMedPubMedCentral Rajan S, Foreman J, Wallis MG, Caldas C, Britton P. Multidisciplinary decisions in breast cancer: does the patient receive what the team has recommended? Br J Cancer. 2013;108(12):2442–7.CrossRefPubMedPubMedCentral
26.
go back to reference Taylor C, Finnegan-John J, Green JS. “No decision about me without me” in the context of cancer multidisciplinary team meetings: a qualitative interview study. BMC Health Serv Res. 2014;14:488.PubMedPubMedCentral Taylor C, Finnegan-John J, Green JS. “No decision about me without me” in the context of cancer multidisciplinary team meetings: a qualitative interview study. BMC Health Serv Res. 2014;14:488.PubMedPubMedCentral
27.
go back to reference Fallowfield L, Langridge C, Jenkins V. Communication skills training for breast cancer teams talking about trials. Breast (Edinburgh, Scotland). 2014;23(2):193–7.CrossRef Fallowfield L, Langridge C, Jenkins V. Communication skills training for breast cancer teams talking about trials. Breast (Edinburgh, Scotland). 2014;23(2):193–7.CrossRef
28.
go back to reference El Saghir N, Charara R, Kreidieh F, Eaton V, Litvin K, Farhat R, Khoury K, Breidy J, Tamim H, Eid T. Global practice and efficiency of multidisciplinary tumor boards: results of an American Society of Clinical Oncology international survey. J Global Oncol. 2015;1(2):57–64.CrossRef El Saghir N, Charara R, Kreidieh F, Eaton V, Litvin K, Farhat R, Khoury K, Breidy J, Tamim H, Eid T. Global practice and efficiency of multidisciplinary tumor boards: results of an American Society of Clinical Oncology international survey. J Global Oncol. 2015;1(2):57–64.CrossRef
29.
go back to reference Jalil R, Ahmed M, Green JS, Sevdalis N. Factors that can make an impact on decision-making and decision implementation in cancer multidisciplinary teams: an interview study of the provider perspective. Int J Surg. 2013;11(5):389–94.CrossRefPubMed Jalil R, Ahmed M, Green JS, Sevdalis N. Factors that can make an impact on decision-making and decision implementation in cancer multidisciplinary teams: an interview study of the provider perspective. Int J Surg. 2013;11(5):389–94.CrossRefPubMed
30.
go back to reference Oxenberg J, Papenfuss W, Esemuede I, Attwood K, Simunovic M, Kuvshinoff B, et al. Multidisciplinary cancer conferences for gastrointestinal malignancies result in measureable treatment changes: a prospective study of 149 consecutive patients. Ann Surg Oncol. 2015;22(5):1533–9.CrossRefPubMed Oxenberg J, Papenfuss W, Esemuede I, Attwood K, Simunovic M, Kuvshinoff B, et al. Multidisciplinary cancer conferences for gastrointestinal malignancies result in measureable treatment changes: a prospective study of 149 consecutive patients. Ann Surg Oncol. 2015;22(5):1533–9.CrossRefPubMed
31.
go back to reference Ryan J, Faragher I. Not all patients need to be discussed in a colorectal cancer MDT meeting. Color Dis. 2014;16(7):520–6.CrossRef Ryan J, Faragher I. Not all patients need to be discussed in a colorectal cancer MDT meeting. Color Dis. 2014;16(7):520–6.CrossRef
32.
go back to reference Harris J, Green JS, Sevdalis N, Taylor C. Using peer observers to assess the quality of cancer multidisciplinary team meetings: a qualitative proof of concept study. J Multidiscip Healthc. 2014;7:355–63.CrossRefPubMedPubMedCentral Harris J, Green JS, Sevdalis N, Taylor C. Using peer observers to assess the quality of cancer multidisciplinary team meetings: a qualitative proof of concept study. J Multidiscip Healthc. 2014;7:355–63.CrossRefPubMedPubMedCentral
33.
go back to reference Lamb BW, Wong HW, Vincent C, Green JS, Sevdalis N. Teamwork and team performance in multidisciplinary cancer teams: development and evaluation of an observational assessment tool. BMJ Qual Saf. 2011;20(10):849–56.CrossRefPubMed Lamb BW, Wong HW, Vincent C, Green JS, Sevdalis N. Teamwork and team performance in multidisciplinary cancer teams: development and evaluation of an observational assessment tool. BMJ Qual Saf. 2011;20(10):849–56.CrossRefPubMed
34.
go back to reference Harris J, Taylor C, Sevdalis N, Jalil R, Development GJS. Testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT). International journal for quality in health care : journal of the international society for. Quality in Health Care. 2016;28(3):332–8.CrossRef Harris J, Taylor C, Sevdalis N, Jalil R, Development GJS. Testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT). International journal for quality in health care : journal of the international society for. Quality in Health Care. 2016;28(3):332–8.CrossRef
Metadata
Title
Benefits, barriers and opinions on multidisciplinary team meetings: a survey in Swedish cancer care
Authors
Linn Rosell
Nathalie Alexandersson
Oskar Hagberg
Mef Nilbert
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-2990-4

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