title: Formalising multidisciplinary peer review: developing a haematological malignancy-specific electronic proforma and standard operating procedure to facilitate procedural efficiency and evidence-based clinical practice.
abstract: BACKGROUND
  Multidisciplinary team (MDT) meetings aimed at facilitating peer review have become standard practice in oncology. However, there is scant literature on the optimal structure and conduct of such meetings.
  
  
  OBJECTIVE
  To develop a process for formal peer review of patients with haematological malignancies and to audit any resulting changes made to the management recommendations of the treating physician.
  
  
  METHODS
  A standard operating procedure (SOP) for MDT meetings was developed essentially to integrate clinical peer review with weekly pathology and radiology meetings. The centrepiece is the electronic submission of a patient-specific proforma (Microsoft InfoPath) prior to the meeting. It serves as the template for presentation, discussion and recording of recommendations and conclusions. The final verified document is stored in the electronic patient record, and a copy is sent to the general practitioner. The proposed management plans were compared to the consensus recommendations of the meeting for the first 4 years since inception.
  
  
  RESULTS
  Both SOP and proforma underwent continual improvements. These provided the framework for the conduct of a robust weekly MDT meeting for peer review of the management of patients with haematological malignancies. On 20% of occasions, patient management plans were altered to optimise patient care as a direct consequence on peer review at the MDT.
  
  
  CONCLUSIONS
  Our streamlined process, in its ultimate format, has provided a mature and efficient forum for formal peer review in a genuine multidisciplinary environment. Both initial data and informal feedback support its ongoing activity as an integral component of delivering quality patient care.
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.|Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Judith
authors.initials: J
authors.lastname: Trotman
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Trinh
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Yiu Lam
authors.identifier: http://orcid.org/0000-0003-2090-750X
authors.initials: YL
authors.lastname: Kwan
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.|Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Estell
authors.affiliation: Departments of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Fletcher
authors.affiliation: Department of Radiology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Archer
authors.affiliation: Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.|Departments of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.|Department of Radiation Oncology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Kerwin
authors.initials: K
authors.lastname: Foo
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.|Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Curnow
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bianchi
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Lynda
authors.initials: L
authors.lastname: Wignall
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Verner
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.|Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Robin
authors.initials: R
authors.lastname: Gasiorowski
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Siedlecka
authors.affiliation: Departments of Haematology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.|Department of Medicine, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Ilona
authors.initials: I
authors.lastname: Cunningham
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making / Q000379:methods*; D019317:Evidence-Based Medicine / Q000379:methods* / Q000592:standards; D005260:Female; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000592:standards; D010380:Peer Review / Q000379:methods* / Q000592:standards; D055815:Young Adult
keywords: haematological neoplasms; interdisciplinary communication; peer review