Quality Improvement in Multidisciplinary Cancer Teams: An Investigation of Teamwork and Clinical Decision-Making and Cross-Validation of Assessments

Lamb, Bernard Charles; Sevdalis, Nick; Mostafid, Hugh; Vincent, Charles; Green, J. S. A.

doi:10.1245/s10434-011-1773-5

Cited by 101 publications

(107 citation statements)

References 36 publications

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“…216 Few tools (12, 16 %) reported response process, which included training raters to correctly use tools. The Multidisciplinary Team Performance Assessment Tool 160,161 is an observational teamwork assessment of cancer teams modified from an established teamwork assessment tool in the surgical literature (Observational Teamwork Assessment in Surgery). [217][218][219] Assessors were trained in the use of this tool by an expert psychologist with experience using the tool.…”

Section: Description and Validity Evidence For Teamwork Assessment Toolsmentioning

confidence: 99%

“…[217][218][219] Assessors were trained in the use of this tool by an expert psychologist with experience using the tool. 160 Reliability of tools was demonstrated by internal consistency (38, 52 %), interrater reliability (16, 22 %), intrarater reliability (1, 1 %), and test-retest reliability (2, 3 %). Reliability estimates for most tools were very good (> 0.7).…”

Section: Description and Validity Evidence For Teamwork Assessment Toolsmentioning

confidence: 99%

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Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

et al. 2013

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OBJECTIVE: Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. DATA SOURCES: We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. STUDY ELIGIBILITY: Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. STUDY APPRAISAL AND SYNTHESIS METHODS:Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. RESULTS: Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. LIMITATIONS: Review is limited to quantitative assessments of teamwork in internal medicine. CONCLUSIONS:There is strong validity evidence for several published tools assessing teamwork in internal medicine. However, few teamwork assessments have been directly linked to patient outcomes. 3,4 Recognizing this, the Institute of Medicine, the Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), and others have made teamwork a top priority in their recommendations for improving healthcare. [5][6][7][8][9] Teamwork is also prominently positioned within the American Board of Internal Medicine (ABIM) requirements for maintenance of certification for internists, 10 as well as the Accreditation Council for Graduate Medical Education's core competencies, 11 milestones, 12 and medical student competencies. 13 As such, every physician at the undergraduate, graduate, and continuing professional level must demonstrate competency in teamwork.While there is broad agreement on the imperative to improve teamwork, there is littl...

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Section: Description and Validity Evidence For Teamwork Assessment Toolsmentioning

confidence: 99%

Section: Description and Validity Evidence For Teamwork Assessment Toolsmentioning

confidence: 99%

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

et al. 2013

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“…Management of patients with PAH would be better served by a multidisciplinary approach that ideally includes healthcare experts to address their needs regarding physical support, as well as mental and social care. This represents a similar multidisciplinary approach to care as required for patients with other chronic diseases such as cystic fibrosis, asthma, heart failure or cancer [89][90][91][92]. Moreover, a similar multidisciplinary approach is often the standard of care for patients with PAH being considered for, or undergoing, lung transplantation.…”

Section: Multidisciplinary Strategies For Pah Managementmentioning

confidence: 99%

Physicians’ and patients’ expectations of therapies for pulmonary arterial hypertension: where do they meet?

2014

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In recent years, many new, effective therapies for pulmonary arterial hypertension (PAH) have become available and are widely used, yet the long-term prognosis for patients with PAH remains poor. In the absence of a cure, physicians' expectations of PAH-specific therapies are to: 1) improve patients' symptoms and functional capacity; 2) slow disease progression; and 3) improve survival. However, patients with PAH may prioritise other more tangible needs, such as improvements in their ability to carry out their daily tasks and increase their quality of life. Patients with PAH have also called out for social and emotional support from their physicians, caregivers, families and patient associations. Therefore, it is necessary that clinical trials of PAH-specific treatments include end-points that are meaningful to both patients and physicians, and that a multidisciplinary approach to the management of patients with PAH takes into consideration the broader aspects of patients' and caregivers' needs and wishes beyond simple physiological measurements. @ERSpublications Treatment and management goals for pulmonary arterial hypertension: meeting both physicians and patients expectations http://ow.ly/Cuezv

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“…Psychological support may be needed for some patients to deal with these issues [Heidenreich et al 2012;White et al 2012], and so a psychologist may be an important addition to the MDT. Generally, participants felt that the MDT should meet weekly [Gomella, 2012;Lamb et al 2011aLamb et al , 2011b.…”

Section: Improving Communicationmentioning

confidence: 99%

Controversies on individualized prostate cancer care: gaps in current practice

Joniau¹,

Pfister

Taille

et al. 2013

Therapeutic Advances in Urology

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Prostate cancer (PCa) is a heterogeneous disease with a wide spectrum of aggressiveness. Evidence-based guidelines are invaluable but cannot be expected to be extensive enough to provide detailed guidance on the management of all patients. As such, the use of individualized, risk-adapted approaches to the management of PCa is indispensable. However, wide variation in treatment approaches observed for patients in practice suggests that there is an unmet need to improve the individualized approach towards patient care. A holistic approach that encompasses guidelines and evidence-based medicine could be used to guide individualized care for patients with PCa, from first contact through to final outcomes. As a result of an international expert meeting, this paper proposes this approach and highlights some of the factors that can be considered when aiming to identify patients' profiles; individualize treatment; and improve communication between patients and the healthcare teams.

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Quality Improvement in Multidisciplinary Cancer Teams: An Investigation of Teamwork and Clinical Decision-Making and Cross-Validation of Assessments

Cited by 101 publications

References 36 publications

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

Physicians’ and patients’ expectations of therapies for pulmonary arterial hypertension: where do they meet?

Controversies on individualized prostate cancer care: gaps in current practice

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