title: Development of a peer-review framework for cancer multidisciplinary meetings.
abstract: BACKGROUND
  There is no mechanism in place for monitoring or quality improvement of cancer multidisciplinary meetings (MDM) in Australia.
  
  
  OBJECTIVE
  To develop a peer-review process for quality improvement of MDM.
  
  
  METHODS
  This project involved three phases: (i) development of a draft peer-review framework, supporting documents and peer-review process; (ii) consultation with key stakeholders; (iii) refinement of the framework, documents and processes following a pilot study with three MDM.
  
  
  RESULTS
  Feedback indicated that specific standards included in the framework needed to allow the peer reviewers to be flexible relative to the circumstances of the individual MDM. Conversely, feedback identified the need for clear, evidence-based clinical practice guidelines for the conduct of MDM, with accepted standards and objective measures of performance. MDM members were divided about the need to employ peer reviewers from the tumour stream of the MDM under review but agreed that closer involvement of the team under review to support the implementation of recommendations is warranted.
  
  
  CONCLUSIONS
  We developed an adaptable peer-review framework and process using the current available evidence and guidance. While further research is needed to establish what constitutes best practice in MDM and which processes contribute to improved patient outcomes, the structured peer-review process we describe, when modified using the disease-relevant evidence, could be utilised more broadly as a quality improvement tool.
authors.affiliation: School of Surgery, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Claire E
authors.identifier: http://orcid.org/0000-0001-9190-8441
authors.initials: CE
authors.lastname: Johnson
authors.affiliation: School of Surgery, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Neli
authors.initials: N
authors.lastname: Slavova-Azmanova
authors.affiliation: School of Surgery, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Christobel
authors.initials: C
authors.lastname: Saunders
mesh_terms: D000066491:Clinical Decision-Making / Q000379:methods*; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis / Q000628:therapy*; D010348:Patient Care Team / Q000592:standards; D010380:Peer Review / Q000379:methods* / Q000592:standards; D011795:Surveys and Questionnaires / Q000592:standards
keywords: accreditation; multidisciplinary cancer care; multidisciplinary team meetings; peer review; quality improvement