Table 2 Comparison of percentages of positive responses to survey questions in 2017 and 2019, ranked by total score of each team in 2019
From: Improving Cancer MDT performance in Western Sydney – three years’ experience
Question | Year | WSLHD | Multidisciplinary teams | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
7 | 10 | 9 | 12 | 1 | 8 | 11 | 6 | 3 | 4 | 5 | 2 | ||||
Meeting Organisation | |||||||||||||||
1 | Is there a dedicated person/position to document meeting outcomes? (yes or no) | 2017 | 66 | 90 | 50 | 90 | 77 | 100 | 45 | 40 | 93 | 38 | 30 | 60 | 60 |
2019 | 91 | 100 | 100 | 100 | 91 | 94 | 80 | 75 | 100 | 100 | 92 | 73 | 75 | ||
2 | Does the MDM have a Terms of Reference or guideline to guide the conduct of the meetings? (yes or no) | 2017 | 15 | 30 | 43 | 10 | 8 | 36 | 9 | 0 | 0 | 25 | 0 | 20 | 0 |
2019 | 55 | 81 | 82 | 54 | 64 | 71 | 38 | 50 | 43 | 40 | 25 | 43 | 13 | ||
3 | Are there established criteria to determine which types of patients should be referred to the MDM? (yes or no) | 2017 | 26 | 70 | 43 | 50 | 38 | 18 | 36 | 10 | 8 | 25 | 0 | 0 | 10 |
2019 | 55 | 69 | 54 | 85 | 45 | 65 | 80 | 50 | 60 | 58 | 33 | 9 | 25 | ||
4 | Is there a follow-up process to check whether referrals are actually made? (yes or no) | 2017 | 14 | 30 | 57 | 30 | 8 | 0 | 18 | 0 | 0 | 0 | 0 | 10 | 0 |
2019 | 30 | 69 | 54 | 62 | 45 | 18 | 10 | 8 | 20 | 8 | 8 | 18 | 25 | ||
Clinical Decision Making | |||||||||||||||
5 | Is consensus documented for each patient as a result of discussion in the meeting? (always and usually) | 2017 | 78 | 90 | 83 | 100 | 100 | 91 | 82 | 90 | 86 | 75 | 30 | 80 | 80 |
2019 | 99 | 100 | 100 | 100 | 100 | 100 | 100 | 100 | 100 | 92 | 100 | 100 | 88 | ||
6 | How often are treatment decisions based on an individual clinician's preference rather than endorsed guidelines or published literature? (rarely or never) | 2017 | 62 | 60 | 42 | 80 | 62 | 91 | 64 | 50 | 79 | 62 | 60 | 30 | 50 |
2019 | 89 | 100 | 85 | 91 | 82 | 100 | 100 | 83 | 80 | 92 | 92 | 82 | 75 | ||
7 | Does the MDM refer to International, National or State Clinical Practice Guidelines or Standard Treatment Protocols when making management decisions for cancer patients from your tumour stream? (always and usually) | 2017 | 63 | 80 | 64 | 80 | 69 | 100 | 82 | 30 | 58 | 63 | 50 | 30 | 40 |
2019 | 76 | 100 | 69 | 85 | 73 | 88 | 90 | 67 | 70 | 92 | 67 | 45 | 38 | ||
Patient Considerations | |||||||||||||||
8 | How often are patients informed that they will be discussed in the MDM? (always and usually) | 2017 | 55 | 40 | 58 | 80 | 38 | 64 | 73 | 70 | 64 | 38 | 40 | 60 | 20 |
2019 | 75 | 63 | 85 | 92 | 91 | 72 | 80 | 100 | 50 | 50 | 92 | 73 | 38 | ||
9 | Is there a formal process for raising patient preferences in the MDM discussions? (yes or no) | 2017 | 16 | 60 | 8 | 0 | 15 | 9 | 27 | 20 | 14 | 25 | 0 | 0 | 30 |
2019 | 32 | 63 | 31 | 46 | 36 | 22 | 40 | 0 | 50 | 33 | 17 | 27 | 0 | ||
10 | How often are patient preferences discussed in the MDM? (always and usually) | 2017 | 59 | 80 | 75 | 60 | 31 | 64 | 82 | 60 | 79 | 25 | 50 | 40 | 30 |
2019 | 60 | 69 | 77 | 67 | 36 | 78 | 80 | 75 | 60 | 42 | 42 | 45 | 38 | ||
11 | How often are supportive care needs (e.g. social, financial, psychological, or others) of patients discussed in the MDM? (always and usually) | 2017 | 26 | 70 | 17 | 20 | 38 | 30 | 27 | 30 | 50 | 13 | 20 | 10 | 0 |
2019 | 33 | 69 | 54 | 25 | 27 | 39 | 30 | 42 | 30 | 17 | 17 | 9 | 25 | ||
12 | Do you routinely collect whether the patient has a psych-oncology screening? (yes or no) | 2017 | 2 | 0 | 0 | 0 | 8 | 0 | 9 | 0 | 7 | 0 | 0 | 0 | 0 |
2019 | 8 | 13 | 15 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||
Quality Improvement and Research | |||||||||||||||
13 | How often are quality improvement activities discussed in, or reported to, the MDM? (at least quarterly) | 2017 | 18 | 20 | 0 | 50 | 31 | 55 | 9 | 0 | 29 | 13 | 0 | 10 | 0 |
2019 | 16 | 38 | 15 | 8 | 36 | 17 | 20 | 17 | 10 | 8 | 8 | 0 | 13 | ||
14 | Are internal audits conducted to confirm that treatment decisions match current best practice? (yes or no) | 2017 | 7 | 20 | 14 | 0 | 8 | 9 | 9 | 0 | 0 | 0 | 10 | 10 | 0 |
2019 | 6 | 25 | 8 | 0 | 18 | 0 | 0 | 0 | 0 | 0 | 17 | 0 | 0 | ||
15 | Do you routinely collect time from diagnosis to active treatment? (yes or no) | 2017 | 10 | 20 | 14 | 33 | 31 | 0 | 0 | 0 | 0 | 25 | 0 | 0 | 0 |
2019 | 16 | 25 | 15 | 25 | 27 | 18 | 10 | 33 | 0 | 17 | 8 | 0 | 0 | ||
16 | Do you routinely collect % of patients seen by the MDM prior to commencement of treatment? (yes or no) | 2017 | 10 | 20 | 0 | 20 | 15 | 0 | 9 | 0 | 29 | 13 | 0 | 0 | 0 |
2019 | 14 | 25 | 15 | 8 | 9 | 6 | 20 | 25 | 20 | 8 | 8 | 9 | 13 | ||
Professional Development | |||||||||||||||
17 | How often are professional development activities made available for MDM members? (at least quarterly) | 2017 | 28 | 10 | 0 | 60 | 31 | 73 | 18 | 60 | 29 | 0 | 40 | 10 | 0 |
2019 | 17 | 38 | 31 | 8 | 36 | 22 | 0 | 25 | 0 | 8 | 0 | 0 | 25 | ||
Total Score | 2017 | 549 | 790 | 568 | 763 | 608 | 740 | 599 | 460 | 625 | 440 | 330 | 370 | 320 | |
2019 | 868 | 1197 | 990 | 929 | 907 | 957 | 938 | 816 | 774 | 699 | 684 | 615 | 541 | ||