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Measuring the quality of MDT working: an observational approach
BACKGROUND: Cancer multidisciplinary teams (MDTs) are established in many countries but little is known about how well they function. A core activity is regular MDT meetings (MDMs) where treatment recommendations are agreed. A mixed methods descriptive study was conducted to develop and test quality...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489862/ https://www.ncbi.nlm.nih.gov/pubmed/22642614 http://dx.doi.org/10.1186/1471-2407-12-202 |
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author | Taylor, Cath Atkins, Louise Richardson, Alison Tarrant, Ruth Ramirez, Amanda-Jane |
author_facet | Taylor, Cath Atkins, Louise Richardson, Alison Tarrant, Ruth Ramirez, Amanda-Jane |
author_sort | Taylor, Cath |
collection | PubMed |
description | BACKGROUND: Cancer multidisciplinary teams (MDTs) are established in many countries but little is known about how well they function. A core activity is regular MDT meetings (MDMs) where treatment recommendations are agreed. A mixed methods descriptive study was conducted to develop and test quality criteria for observational assessment of MDM performance calibrated against consensus from over 2000 MDT members about the “characteristics of an effective MDT”. METHODS: Eighteen of the 86 ‘Characteristics of Effective MDTs’ were considered relevant and feasible to observe. They collated to 15 aspects of MDT working covering four domains: the team (e.g. attendance, chairing, teamworking); infrastructure for meetings (venue, equipment); meeting organisation and logistics; and patient-centred clinical decision-making (patient-centredness, clarity of recommendations). Criteria for rating each characteristic from ‘very poor’ to ‘very good’ were derived from literature review, observing MDMs and expert input. Criteria were applied to 10 bowel cancer MDTs to assess acceptability and measure variation between and within teams. Feasibility and inter-rater reliability was assessed by comparing three observers. RESULTS: Observational assessment was acceptable to teams and feasible to implement. Total scores from 29 to 50 (out of 58) highlighted wide diversity in quality between teams. Eight teams were rated either ‘very good/good’ or ‘very poor/poor’ for at least three domains demonstrating some internal consistency. ‘Very good’ ratings were most likely for attendance and administrative preparation, and least likely for patient-centredness of decision-making and prioritisation of complex cases. All except two characteristics had intra-class correlations of ≥0.50. CONCLUSIONS: This observational tool (MDT-OARS) may contribute to the assessment of MDT performance. Further testing to confirm validity and reliability is required. |
format | Online Article Text |
id | pubmed-3489862 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-34898622012-11-06 Measuring the quality of MDT working: an observational approach Taylor, Cath Atkins, Louise Richardson, Alison Tarrant, Ruth Ramirez, Amanda-Jane BMC Cancer Research Article BACKGROUND: Cancer multidisciplinary teams (MDTs) are established in many countries but little is known about how well they function. A core activity is regular MDT meetings (MDMs) where treatment recommendations are agreed. A mixed methods descriptive study was conducted to develop and test quality criteria for observational assessment of MDM performance calibrated against consensus from over 2000 MDT members about the “characteristics of an effective MDT”. METHODS: Eighteen of the 86 ‘Characteristics of Effective MDTs’ were considered relevant and feasible to observe. They collated to 15 aspects of MDT working covering four domains: the team (e.g. attendance, chairing, teamworking); infrastructure for meetings (venue, equipment); meeting organisation and logistics; and patient-centred clinical decision-making (patient-centredness, clarity of recommendations). Criteria for rating each characteristic from ‘very poor’ to ‘very good’ were derived from literature review, observing MDMs and expert input. Criteria were applied to 10 bowel cancer MDTs to assess acceptability and measure variation between and within teams. Feasibility and inter-rater reliability was assessed by comparing three observers. RESULTS: Observational assessment was acceptable to teams and feasible to implement. Total scores from 29 to 50 (out of 58) highlighted wide diversity in quality between teams. Eight teams were rated either ‘very good/good’ or ‘very poor/poor’ for at least three domains demonstrating some internal consistency. ‘Very good’ ratings were most likely for attendance and administrative preparation, and least likely for patient-centredness of decision-making and prioritisation of complex cases. All except two characteristics had intra-class correlations of ≥0.50. CONCLUSIONS: This observational tool (MDT-OARS) may contribute to the assessment of MDT performance. Further testing to confirm validity and reliability is required. BioMed Central 2012-05-29 /pmc/articles/PMC3489862/ /pubmed/22642614 http://dx.doi.org/10.1186/1471-2407-12-202 Text en Copyright ©2012 Taylor et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Taylor, Cath Atkins, Louise Richardson, Alison Tarrant, Ruth Ramirez, Amanda-Jane Measuring the quality of MDT working: an observational approach |
title | Measuring the quality of MDT working: an observational approach |
title_full | Measuring the quality of MDT working: an observational approach |
title_fullStr | Measuring the quality of MDT working: an observational approach |
title_full_unstemmed | Measuring the quality of MDT working: an observational approach |
title_short | Measuring the quality of MDT working: an observational approach |
title_sort | measuring the quality of mdt working: an observational approach |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489862/ https://www.ncbi.nlm.nih.gov/pubmed/22642614 http://dx.doi.org/10.1186/1471-2407-12-202 |
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