Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature

Abstract

In many health care systems globally, cancer care is driven by multidisciplinary cancer teams (MDTs). A large number of studies in the past few years and across different literature have been performed to better understand how these teams work and how they manage patient care. The aim of our literature review is to synthesize current scientific and clinical understanding on cancer MDTs and their organization; this, in turn, should provide an up-to-date summary of the current knowledge that those planning or leading cancer services can use as a guide for service implementation or improvement. We describe the characteristics of an effective MDT and factors that influence how these teams work. A range of factors pertaining to teamwork, availability of patient information, leadership, team and meeting management, and workload can affect how well MDTs are implemented within patient care. We also review how to assess and improve these teams. We present a range of instruments designed to be used with cancer MDTs – including observational tools, self-assessments, and checklists. We conclude with a practical outline of what appears to be the best practices to implement (Dos) and practices to avoid (Don’ts) when setting up MDT-driven cancer care.

Referral rates to multidisciplinary team meetings: Is there disparity between tumour streams?

“…Important aspects of a successful MDTM are communication and leadership, both of which are shown by the specialists within these teams. Having leaders who understand the importance of protected time for meetings and preparation can improve the quality and efficiency of the meetings, allowing more patients to be discussed …”

“…Studies have shown that cancer care coordinators improve effectiveness of MDTMs . While their role varies slightly between health centres, it is important to have a key person to ensure communication between the MDTM, the patient and their health service . They ensure a continuum of care for patients from diagnosis to treatment and follow‐up, and can assist with organising MDTMs.…”

“…Having leaders who understand the importance of protected time for meetings and preparation can improve the quality and efficiency of the meetings, allowing more patients to be discussed. 4,5 Within our health service, patients diagnosed with genitourinary cancer were the least likely to be discussed at a MDTM. In particular, prostate cancer patients had a referral rate to the MDTM of 28% (122/435 patients) in 2015.…”

“…As this approach becomes standard of care in most hospitals in Australia, there will be increasing challenges to creating efficient MDT meetings (MDTM). Strategies such as dedicated time for meeting preparation and effective leadership and teamwork are key to successful meetings that will ensure high quality care for cancer patients …”

“…Strategies such as dedicated time for meeting preparation and effective leadership and teamwork are key to successful meetings that will ensure high quality care for cancer patients. 5 Given the overwhelming evidence supporting the role of multidisciplinary care in the management of cancer patients, the aim of this retrospective study is to review the proportion of patients within the Sunshine Coast Hospital and Health Service (SCHHS) being discussed at MDTMs. It also aims to identify referral patterns and potential reasons why some patients might not be discussed.…”