A pre-post test evaluation of the impact of the PELICAN MDT-TME Development Programme on the working lives of colorectal cancer team members

Abstract

BackgroundThe PELICAN Multidisciplinary Team Total Mesorectal Excision (MDT-TME) Development Programme aimed to improve clinical outcomes for rectal cancer by educating colorectal cancer teams in precision surgery and related aspects of multidisciplinary care. The Programme reached almost all colorectal cancer teams across England. We took the opportunity to assess the impact of participating in this novel team-based Development Programme on the working lives of colorectal cancer team members.MethodsThe impact of participating in the programme on team members' self-reported job stress, job satisfaction and team performance was assessed in a pre-post course study. 333/568 (59%) team members, from the 75 multidisciplinary teams who attended the final year of the Programme, completed questionnaires pre-course, and 6-8 weeks post-course.ResultsAcross all team members, the main sources of job satisfaction related to working in multidisciplinary teams; whilst feeling overloaded was the main source of job stress. Surgeons and clinical nurse specialists reported higher levels of job satisfaction than team members who do not provide direct patient care, whilst MDT coordinators reported the lowest levels of job satisfaction and job stress. Both job stress and satisfaction decreased after participating in the Programme for all team members. There was a small improvement in team performance.ConclusionsParticipation in the Development Programme had a mixed impact on the working lives of team members in the immediate aftermath of attending. The decrease in team members' job stress may reflect the improved knowledge and skills conferred by the Programme. The decrease in job satisfaction may be the consequence of being unable to apply these skills immediately in clinical practice because of a lack of required infrastructure and/or equipment. In addition, whilst the Programme raised awareness of the challenges of teamworking, a greater focus on tackling these issues may have improved working lives further.

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

“…25,26 In addition, the satisfaction of patients and healthcare professionals are increasingly seen as important measures of the effectiveness of healthcare. 27,28 The results of this study should be interpreted in the light of certain limitations. First, the sample of MDT meetings comes from a single hospital and may not be representative of MDTs in general.…”

The importance of pathological quality control for rectal surgery

“…Education programmes directed primarily at surgeons have been shown to improve the oncological quality of surgical specimens and patient outcomes in Netherlands, Norway and Sweden [13] . The National Pelican MDT TME Development Programme was an educational programme aimed at the whole CRC MDT and was delivered through the Pelican Cancer Foundation in England [36] . Although there is limited evidence for the direct effect of the programme, outcomes for rectal cancer patients in the UK were significantly improved over this time period and a further government funded National MDT educational programme focusing on low rectal cancer called the Low Rectal Cancer Development Programme (LOREC) was launched a few years later [37] .…”

Multidisciplinary team management in thoracic oncology: more than just a concept?

“…In addition to the opportunity for education and self-appraisal and support for decision making, it has also been suggested that the cancer MDT meeting is enjoyed by some clinicians and that their job satisfaction improved as a result [46,47]. One of the predominant reasons for this seems to be the feeling that they provide their patients with a better service [47], and the MDT provides a means of monitoring and assessing services at both local and national levels.…”

“…One of the predominant reasons for this seems to be the feeling that they provide their patients with a better service [47], and the MDT provides a means of monitoring and assessing services at both local and national levels. Important issues surrounding the care of an individual patient may be identified by one member of the team, or audits of MDT practice may be performed, which can be presented to the whole team so that changes to the service can be made with the input and agreement of all team members.…”