How acceptable and beneficial do clinicians think peer review of multidisciplinary cancer teams is? — ASN Events

How acceptable and beneficial do clinicians think peer review of multidisciplinary cancer teams is? (#221)

Claire E Johnson 1 , Neli Slavova-Azmanova 1 , Martin Phillips 2 , Cameron Platell 1 3 , Sean Bydder 4 , Christobel Saunders 1
  1. School of Surgery, The University of Western Australia, Perth, Western Australia, Australia
  2. Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
  3. Colorectal Cancer Unit, St John of God Hospital Subiaco, Perth, WA, Australia
  4. Radiation Oncology, Sir Charles Gairdner Hospital, Perth, WA, Australia

Aim: To explore clinicians’ perceptions of the peer review of multidisciplinary cancer teams (MDTs) guided by a peer review framework for quality improvement.

Methods: Semi-structured interviews were conducted with 17 consenting members (N=25) of three well-functioning MDTs after pilot testing a peer review process. Thematic analysis was conducted using a framework approach. Data were grouped into three a priori themes: the peer review process; the report; and, peer review recommendations.

Results: Ten doctors, five nurses and two allied health professionals were interviewed.
Despite the differences between the MDTs, participants found the process reasonable, constructive and useful, and motivated teams to look at different ways to improve their services. However, several participants considered the process to be bureaucratic and time consuming. Most interviewees found the final report to be accurate and reflective of the service. Some participants felt that the report underestimated the MDTs’ maturity and the role of some members.

Responses to the recommendations resulting from the peer review were mixed. Most participants thought all or some of the recommendations were helpful but some suggestions had been considered by the teams previously. Participant responses within MDTs to individual recommendations also varied. In a number of instances, several members of one MDT perceived a recommendation to be particularly relevant, while other members of the same team viewed it as impractical or of limited value. Many participants were doubtful about the extent to which recommendations would be implemented, with issues such as lack of resources, lack of time, competing priorities within the MDT and ongoing hospital infrastructure changes cited as barriers.

Conclusion: Using clinical peers to subjectively assess and provide feedback to well-functioning MDTs was feasible and acceptable but the perceived benefit was variable. Measuring benefit is difficult without widely utilised objective outcome measures.