Table 1 Cluster (team) adjusted OR and 95% CI for ‘positive’ responses comparing 2017 to 2019 and associated P values for the 19 questions
From: Improving Cancer MDT performance in Western Sydney – three years’ experience
Survey Questions | OR 2019 vs 2017a | 95% CI for OR | P valueb | ||
|---|---|---|---|---|---|
lower | upper | ||||
Meeting Organisation | |||||
1 | Is there a dedicated person/position to document meeting outcomes? | 5.1 | 2.6 | 10.0 | <0.001** |
2 | Does the MDM have a Terms of Reference or guideline to guide the conduct of the meetings? | 6.6 | 3.1 | 14.2 | <0.001** |
3 | Are there established criteria to determine which types of patients should be referred to the MDM? | 3.3 | 2.1 | 5.2 | <0.001** |
4 | Is there a follow-up process to check whether referrals are actually made? | 2.7 | 1.0 | 7.0 | 0.046* |
Clinical Decision Making | |||||
5 | Is consensus documented for each patient as a result of discussion in the meeting? | 14.8 | 3.6 | 61.1 | <0.001** |
6 | How often are treatment decisions based on an individual clinician's preference rather than endorsed guidelines or published literature? (Always or Usually) | 0.2d | 0.1 | 0.3 | <0.001** |
7 | Does the MDM refer to International, National or State Clinical Practice Guidelines or Standard Treatment Protocols when making management decisions for cancer patients from your tumour stream? | 1.8 | 1.3 | 2.5 | 0.001* |
Patient Considerations | |||||
8 | How often are patients informed that they will be discussed in the MDM? | 2.5 | 1.4 | 4.3 | 0.002* |
9 | Is there a formal process for raising patient preferences in the MDM discussions? | 2.2 | 1.3 | 3.8 | 0.05* |
10 | How often are patient preferences discussed in the MDM? | 1.1 | 0.9 | 14.5 | 0.357 |
11 | How often are supportive care needs (e.g. social, financial, psychological, or others) of patients discussed in the MDM? | 1.2 | 0.9 | 1.7 | 0.148 |
12 | Do you routinely collect whether the patient has a psych-oncology screening? | 1.2 | 0.3 | 4.5 | 0.779 |
Quality Improvement and Research | |||||
13 | How often are quality improvement activities discussed in, or reported to, the MDM? | 0.9 | 0.4 | 1.8 | 0.685 |
14 | Are internal audits conducted to confirm that treatment decisions match current best practice? | 0.9 | 0.4 | 1.9 | 0.725 |
15 | Do you routinely collect time from diagnosis to active treatment? | 1.6 | 0.8 | 3.3 | 0.174 |
16 | Do you routinely collect % of patients seen by the MDM prior to commencement of treatment? | 1.6 | 0.7 | 3.3 | 0.253 |
Education/Professional Development | |||||
17 | How often are professional development activities made available for MDM members? | 0.5 | 0.2 | 1.2 | 0.119 |