Peer Review of Multidisciplinary cancer teams: a pilot study — ASN Events

Peer Review of Multidisciplinary cancer teams: a pilot study (#234)

Neli Slavova-Azmanova 1 , Christobel Saunders 2 , Rhonda Coleman 3 , Martin Phillips 4 , Cameron Platell 2 , Sean Bydder 5 , Claire Johnson 1
  1. Cancer and Palliative Care Research and Evaluation Unit , The University of Western Australia, Perth, WA, Australia
  2. School of Surgery, The University of Western Australia, Perth, WA, Australia
  3. WA Cancer and Palliative Care Network, Department of Health WA, Perth, WA, Australia
  4. Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
  5. Radiation Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia

Background: Multidisciplinary cancer teams (MDTs) are well established in Australia, however a recent audit found that they often function outside best practice guidelines. Peer review of MDTs may provide useful benefits.

Aim: To explore the feasibility of MDT peer review using a specifically developed tool.  

Method: A Peer Review Framework (PRF) was developed to guide the assessment of MDTs by a Peer Review Team (PRT). The PRF covers seven domains: team structure and governance; membership and leadership; meeting organisation and support; quality assurance; standards of care; patient involvement; and, professional development.

The PRF was trialled with three well-functioning metropolitan MDTs. PRT consisted of four multidisciplinary clinicians. The PRT observed one video recorded MDT meeting (MDM) and subsequently met with key members of each MDT. The PRT also reviewed a self-reported questionnaire from the MDT, documentation provided by the MDT, the hospital medical records of selected patients and the result of patient questionnaires (investigating knowledge and experiences of the MDT).

Results: The PRT found all three MDTs were well established and organised. Good clinical leadership and core and non-core membership provided thorough discussions and holistic care to the presented patients. MDMs treatment decisions were based on consensus approach. However, MDTs lacked operational policies and procedures to govern their functioning.

Recommendations were made for improvement in records of the MDT attendance and treatment decisions; communication about MDM treatment recommendations with GPs and patients; and, consideration of electronic capture of MDT data in real time. The PRT recognised the educational value of the MDMs and the high workload for those presenting at the meetings.

Conclusion: The PRF was a useful tool to facilitate formal, ongoing monitoring and the provision of feedback to MDTs.  Although the process was well accepted by the PRT and the MDTs, it is still to be seen whether it will lead to changes in the involved teams.