title: Development and testing of the cancer multidisciplinary team meeting observational tool (MDT-MOT).
abstract: OBJECTIVE
  To develop a tool for independent observational assessment of cancer multidisciplinary team meetings (MDMs), and test criterion validity, inter-rater reliability/agreement and describe performance.
  
  
  METHODS
  Clinicians and experts in teamwork used a mixed-methods approach to develop and refine the tool. Study 1 observers rated pre-determined optimal/sub-optimal MDM film excerpts and Study 2 observers independently rated video-recordings of 10 MDMs.
  
  
  METHODS
  Study 2 included 10 cancer MDMs in England.
  
  
  METHODS
  Testing was undertaken by 13 health service staff and a clinical and non-clinical observer.
  
  
  METHODS
  None.
  
  
  METHODS
  Tool development, validity, reliability/agreement and variability in MDT performance.
  
  
  RESULTS
  Study 1: Observers were able to discriminate between optimal and sub-optimal MDM performance (P ≤ 0.05). Study 2: Inter-rater reliability was good for 3/10 domains. Percentage of absolute agreement was high (≥80%) for 4/10 domains and percentage agreement within 1 point was high for 9/10 domains. Four MDTs performed well (scored 3+ in at least 8/10 domains), 5 MDTs performed well in 6-7 domains and 1 MDT performed well in only 4 domains. Leadership and chairing of the meeting, the organization and administration of the meeting, and clinical decision-making processes all varied significantly between MDMs (P ≤ 0.01).
  
  
  CONCLUSIONS
  MDT-MOT demonstrated good criterion validity. Agreement between clinical and non-clinical observers (within one point on the scale) was high but this was inconsistent with reliability coefficients and warrants further investigation. If further validated MDT-MOT might provide a useful mechanism for the routine assessment of MDMs by the local workforce to drive improvements in MDT performance.
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Harris
authors.affiliation: Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: Cath
authors.initials: C
authors.lastname: Taylor
authors.affiliation: Centre for Implementation Science, Health Service and Population Research Department, King's College London, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
authors.affiliation: Urology department, Imperial College NHS Trust, London, UK.
authors.forename: Rozh
authors.initials: R
authors.lastname: Jalil
authors.affiliation: Department of Urology, Barts Health NHS Trust, Whipps Cross Hospital, London, UK Department of Health and Social Care, London South Bank University, London, UK.
authors.forename: James S A
authors.initials: JS
authors.lastname: Green
mesh_terms: D000066491:Clinical Decision-Making; D004739:England; D004777:Environment; D006126:Group Processes; D006801:Humans; D007857:Leadership; D008495:Medical Oncology; D009369:Neoplasms / Q000628:therapy*; D015588:Observer Variation; D015279:Organizational Culture; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D018802:Patient-Centered Care / Q000458:organization & administration; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: cancer; multidisciplinary team; observation; patient care team; quality assessment; teamwork