Multidisciplinary cancer team meeting structure and treatment decisions: a prospective correlational study.
BACKGROUND
Anecdotally, organizational factors appear to have an effect on the quality of decision-making in the multidisciplinary team (MDT) meeting. We assess the effect of the number of team-members present, number and order of cases, and the timing of meetings on the process of decision-making in MDT meetings.


METHODS
Between December 2009 and January 2010, data were prospectively collected on treatment decisions, meeting characteristics, quality of information, and teamworking for all cases discussed at a London-based MDT meeting. Variables measured using a validated assessment tool (MDT MODe) and correlational analyses were performed.


RESULTS
Treatment decisions were reached in 254 of 298 (85%) cases. Cases toward the end of meetings were associated with lower rates of decision-making, information quality, and teamworking (r = -0.15 to -0.37). Increased number of cases per meeting and team members in attendance were associated with better information and teamworking (r = 0.29-0.43). More time per case was associated with improved teamworking (r = 0.16). A positive correlation was obtained between ability to reach decisions and improved information and teamworking (r = 0.36-0.54; all P ≤ 0.001).


CONCLUSIONS
Organizational factors related to the structure of the MDT meeting are associated with variation in the likelihood of reaching a treatment decision. Further research is required to establish causation and to modify such factors in order to improve the quality of cancer care.
Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, 5th Floor Medical School Building, St. Mary's Hospital, London, W2 1PG, UK. benjamin.lamb@imperial.ac.uk
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BW
Lamb
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Sevdalis
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J
Benn
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Vincent
J S A
JS
Green
D003657:Decision Making; D006801:Humans; D033183:Interdisciplinary Communication; D008495:Medical Oncology / Q000458:organization & administration*; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration*; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D011787:Quality of Health Care