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Teamwork and Team Decision-making at Multidisciplinary Cancer Conferences: Barriers, Facilitators, and Opportunities for Improvement

Published on Sep 1, 2011in World Journal of Surgery2.768
· DOI :10.1007/s00268-011-1152-1
Benjamin W. Lamb13
Estimated H-index: 13
(Imperial College London),
Nick Sevdalis54
Estimated H-index: 54
(Imperial College London)
+ 3 AuthorsJames Green27
Estimated H-index: 27
Abstract
Background Anecdotally, multidisciplinary cancer conferences (MCCs) do not always function optimally. MCC members’ experiences with and attitudes toward MCCs are explored, and barriers to and facilitators of effective team-working are identified.
  • References (32)
  • Citations (55)
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References32
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#1Benjamin W. Lamb (Imperial College London)H-Index: 13
#2Heather Payne (UCL: University College London)H-Index: 9
Last. James GreenH-Index: 27
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Background and aims In the UK, cancer care is managed via multidisciplinary teams (MDT). Core members of these teams are typically surgeons, oncologists, radiologists, pathologists and clinical nurse specialists (with other health care professionals potentially present). Good teamwork, including team communication and leadership, has been shown to be a prerequisite for safe care delivery in other health care contexts, but cancer MDT team working processes are yet to be fully explored. This study...
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#1Benjamin W. LambH-Index: 13
#2Helen W. L. WongH-Index: 8
Last. Nick SevdalisH-Index: 54
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Aim Team performance is important in multidisciplinary teams (MDTs), but no tools exist for assessment. Our objective was to construct a robust tool for scientific assessment of MDT performance. Materials and methods An observational tool was developed to assess performance in MDTs. Behaviours were scored on Likert scales, with objective anchors. Five MDT meetings (112 cases) were observed by a surgeon and a psychologist. The presentation of case history, radiological and pathological informatio...
52 CitationsSource
#1B. W. Lamb (Imperial College London)H-Index: 7
#2Judith GreenH-Index: 41
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Decisions in surgical oncology are increasingly being made by multi-disciplinary teams (MDTs). Although MDTs have been widely accepted as the preferred model for cancer service delivery, the process of decision making has not been well described and there is little evidence pointing to the ideal structure of an MDT. Performance in surgery has been shown to depend on non-technical skills, such as decision making, as well as patient factors and the technical skills of the healthcare team. Applicat...
46 CitationsSource
#1Benjamin W. Lamb (Imperial College London)H-Index: 13
#2Katrina F. Brown (Imperial College London)H-Index: 10
Last. Nick Sevdalis (Imperial College London)H-Index: 54
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178 CitationsSource
#1Bianca DevittH-Index: 6
#2Jennifer PhilipH-Index: 19
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As the complexity of cancer treatment increases so too has the need for coordination between health care professionals. Multidisciplinary meetings are a useful tool in treating patients with cancer and are shown to improve survival and adherence to evidence based-guidelines.
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#2Rolv-Ole LindsetmoH-Index: 17
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Background Little is known regarding variations in preoperative treatment and practice for rectal cancer (RC) on an international level, yet practice variation may result in differences in recurrence and survival rates.
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#1Nicole J. Look Hong (U of T: University of Toronto)H-Index: 3
#2Frances C. Wright (U of T: University of Toronto)H-Index: 29
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Background and Objectives The aim of this review is to examine the relationship between multidisciplinary cancer care and patient survival. Methods A literature review was undertaken between January 1950 and September 2009. Included studies described multidisciplinary cancer care and its relation to patient survival. Multidisciplinary care was defined as involvement of a team of clinical and allied specialists whose intent is individualized patient management. Studies were critically appraised f...
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#1Cath TaylorH-Index: 17
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Last. Amanda-Jane RamirezH-Index: 29
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#1Roger KneeboneH-Index: 38
#2Heather FryH-Index: 4
In this chapter we describe the characteristics of qualitative research, considering why and when it might be used within surgical practice. We highlight similarities and differences between qualitative and quantitative approaches, exploring some common misconceptions. The characteristics of qualitative research are described; the key qualitative methods used in different types of enquiry into surgical practice are then outlined. Finally, we consider some practical issues around conducting and i...
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#1Frances C. Wright (Sunnybrook Health Sciences Centre)H-Index: 29
#2N. Lookhong (Sunnybrook Health Sciences Centre)H-Index: 1
Last. Anna R. Gagliardi (Sunnybrook Health Sciences Centre)H-Index: 11
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Background Cancer care is complex and multimodal therapy is now considered the standard of care. Multidisciplinary cancer conferences (MCCs) offer a venue to prospectively discuss cancer patients and plan treatment. MCCs are believed to improve patient outcomes and consequently have been internationally adopted. The purpose of this study was to describe the prevalence of MCCs in Ontario and identify individual and organizational barriers to their adoption.
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#1Duilio Pagano (ISMETT)H-Index: 14
#2Salvatore Gruttadauria (ISMETT)H-Index: 26
The preoperative assessment of patients with complex comorbidities is central in aiding the decision-making process for treating patients with hepatobiliary cancer and/or end-stage liver disease. Inappropriate surgical approaches or lack of evaluation of patients with challenging medical problems can compromise the patient care of those who have several comorbidities and are at higher risk of developing postoperative complications, with loss of functional residual reserve, and affect health care...
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Despite evidence that referral to pediatric palliative care reduces suffering and improves quality of life for patients and families, many clinicians delay referral until the end of life. The purpose of this article is to provide a conceptual model for why clinical teams delay discussing palliative care with parents. Building on a prior model of parent regoaling and relevant research literature, we argue for a conceptual model of the challenges and facilitators a clinical team might face in shif...
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#1Isla WallaceH-Index: 5
#2Helen BarrattH-Index: 8
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Abstract Purpose There are well-documented barriers to nurse participation in cancer multidisciplinary team (MDT) meetings. This paper aims to identify the approaches used by Clinical Nurse Specialists (CNSs) in this setting to contribute during discussion, and to consider the impact of these approaches on the decision making process. In doing so it aims to highlight ways that CNSs can increase their influence, and enhance multidisciplinary engagement. Methods This study is based on analysis of ...
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Multidisciplinary team meetings have several flaws; herein, we propose approaches for cancer centres to transform these limitations into improvements in the quality control of oncological care and into research opportunities.
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#2Brittany Speller (St. Michael's Hospital)H-Index: 1
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Abstract Aim International guidelines highlight the importance of implementation supports and quality monitoring of multidisciplinary care for breast cancer. In Canada, Ontario has standards for formal multidisciplinary cancer conferences (MCCs), but other provinces/territories do not. This study aimed to stocktake MCCs for breast cancer in Canadian sites participating in the RUBY cohort study (Reducing the Burden of Breast Cancer in Young Women) to better understand variations in multidisciplin...
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#1T. A. K. Gandamihardja (Broomfield Hospital)H-Index: 1
#2Tayana Soukup ('KCL': King's College London)H-Index: 5
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#1Syed Nabeel Zafar (HU: Howard University)H-Index: 22
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