title: Multidisciplinary cancer care in Australia: a national audit highlights gaps in care and medico-legal risk for clinicians.
abstract: OBJECTIVE
  Multidisciplinary care (MDC) is accepted as best practice in cancer treatment planning and care. Despite recognition of the importance of a team approach, limited data are available about the extent to which MDC has been implemented in Australia. The aim of the audit was to investigate the implementation of MDC for five main cancer types across Australia in line with best practice.
  
  
  METHODS
  A sample of 155 hospitals was surveyed to investigate the status of MDC for cancer treatment planning in Australia across five cancer types (breast, gynecological, lung, prostate and colorectal). The survey investigated team structure, meetings, patient consent, documentation of team recommendations and communication with the patient.
  
  
  RESULTS
  Two-thirds of hospitals surveyed did not have a multidisciplinary team. Of those with such a team; in one-third patients were not informed their case would be discussed by the team, in half patient consent was not sought for all cases discussed by the team, in one-quarter the team's recommended treatment plan was not noted in the patient record. Less than 1% of teams reported routine attendance by the tumour-specific minimum core team.
  
  
  CONCLUSIONS
  MDC is not being implemented in line with best practice or applied consistently across Australia. This audit has highlighted gaps in care delivery, despite national recommendations about MDC. Areas being neglected can affect the quality of care provided and may put clinicians at medico-legal risk. Recommendations to improve uptake and effectiveness of MDC are provided.
authors.affiliation: National Breast and Ovarian Cancer Centre, Sydney, New South Wales School of Surgery, University of Western Australia, Nedlands, WA, Australia. heidi.wilcoxon@nbocc.org.au
authors.forename: Heidi
authors.initials: H
authors.lastname: Wilcoxon
authors.forename: Karen
authors.initials: K
authors.lastname: Luxford
authors.forename: Christobel
authors.initials: C
authors.lastname: Saunders
authors.forename: Janice
authors.initials: J
authors.lastname: Peterson
authors.forename: Helen
authors.initials: H
authors.lastname: Zorbas
mesh_terms: D002173:Cancer Care Facilities; D019090:Case Management; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D033183:Interdisciplinary Communication; D008485:Medical Audit / Q000706:statistics & numerical data*; D009369:Neoplasms / Q000628:therapy*; D010347:Patient Care Planning / Q000941:ethics / Q000458:organization & administration* / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000331:legislation & jurisprudence*