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Multidisciplinary Meetings (multidisciplinary + meeting)
Selected AbstractsThe impact of case discussion at a multidisciplinary team meeting on the treatment and survival of patients with inoperable non-small cell lung cancerINTERNAL MEDICINE JOURNAL, Issue 12 2009S. Bydder Abstract Patients with inoperable non-small cell lung cancer diagnosed and managed at a single institution over a one-year period were identified. Those whose case had been discussed at a multidisciplinary meeting had better survival than those whose case was not discussed (mean survival; 280 days vs. 205 days, log-rank P= 0.048). [source] Mentoring in the management of hematological malignanciesASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 1 2010Craig UNDERHILL Abstract Aim: The Mentoring in Management of Haematological Malignancies (MMHM) project aimed to improve treatment outcomes, coordinate care and provide best practice for patients with hematological cancers, by developing a program of mentoring and multidisciplinary care between a regional and a metropolitan centre. Methods: A regular multidisciplinary meeting conducted by teleconference was established between a tertiary metropolitan site and a regional practice to discuss cases of patients with hematological malignancies. Information from multidisciplinary team meetings was recorded to capture adherence to process and clinician outcomes. An educational program was developed. A gap analysis was performed to identify differences in routine practice between the two centers. Clinician satisfaction with mentoring and educational interventions was assessed by structured survey. Results: The MMHM project developed a formal mentoring system to improve the management of patients by building on established links and developing an innovative model of web-based multidisciplinary care. The project established a novel multidisciplinary meeting between a metropolitan and regional site. Common treatment policies were adopted between the two sites. Development of an educational framework and mentoring for health-care professionals in regional areas was achieved by tutorials and workshops. Most participating clinicians indicated their high level of satisfaction with the mentoring project. Conclusion: The MMHM project was a successful pilot of a mentoring program in hematological cancers between metropolitan and regional centers that resulted in improved referral links, facilitated better care coordination, updated treatment policies and guidelines and increased clinician satisfaction and knowledge. [source] The BSCC Code of Practice , exfoliative cytopathology (excluding gynaecological cytopathology)CYTOPATHOLOGY, Issue 4 2009A. Chandra Exfoliative cytopathology (often referred to as non-gynaecological cytology) is an important part of the workload of all diagnostic pathology departments. It clearly has a role in the diagnosis of neoplastic disease but its role in establishing non-neoplastic diagnoses should also be recognised. Ancillary tests may be required to establish a definitive diagnosis. Clinical and scientific teamwork is essential to establish an effective cytology service and staffing levels should be sufficient to support preparation, prescreening, on-site adequacy assessment and reporting of samples as appropriate. Routine clinical audit and histology/cytology correlation should be in place as quality control of a cytology service. Cytology staff should be involved in multidisciplinary meetings and appropriate professional networks. Laboratories should have an effective quality management system conforming to the requirements of a recognised accreditation scheme such as Clinical Pathology Accreditation (UK) Ltd. Consultant pathologists should sign out the majority of exfoliative cytology cases. Where specimens are reported by experienced biomedical scientists (BMS), referred to as cytotechnologists outside the UK, this must only be when adequate training has been given and be defined in agreed written local protocols. An educational basis for formalising the role of the BMS in exfoliative cytopathology is provided by the Diploma of Expert Practice in Non-gynaecological Cytology offered by the Institute of Biomedical Science (IBMS). The reliability of cytological diagnoses is dependent on the quality of the specimen provided and the quality of the preparations produced. The laboratory should provide feedback and written guidance on specimen procurement. Specimen processing should be by appropriately trained, competent staff with appropriate quality control. Microscopic examination of preparations by BMS should be encouraged wherever possible. Specific guidance is provided on the clinical role, specimen procurement, preparation and suitable staining techniques for urine, sputum, semen, serous cavity effusion, cerebrospinal fluid, synovial fluid, cyst aspirates, endoscopic specimens, and skin and mucosal scrapes. [source] Group decisions in oncology: Doctors' perceptions of the legal responsibilities arising from multidisciplinary meetingsJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 3 2008MA Sidhom Summary There is growing consensus that multidisciplinary meetings (MDMs) are the optimal means of arriving at a comprehensive treatment plan for cancer patients. However, if a patient was grieved by a decision made by an MDM and wished to recover damages, the courts would find all involved consultants responsible for decisions related to their area of expertise. The aim of this study was to assess (i) whether doctors participating in oncology MDMs are aware that they are individually accountable for the MDM decisions and (ii) whether MDMs are conducted in a way that reflects this individual responsibility. A 35-question survey was developed and peer reviewed. Doctors attending MDMs in four Australian tertiary-care hospitals were invited to respond. One hundred and thirty-six responses (91% response rate) were received from 18 MDMs across 4 hospitals. Only 48% of doctors believe they are individually liable for decisions made by the MDM. This awareness was greater for an MDM where the patient attends, than in those that were ,discussion only' (58 vs 37%; P = 0.036). Seventy-three per cent stated they would like further education about their legal responsibilities in MDMs. Thirty-three per cent of doctors feel that the MDM discussion environment is suboptimal and radiation oncologists are significantly more likely to hold this view. Even though 85% of doctors have disagreed with the final MDM decision in an important way at some time, 71% did not formally dissent on those occasions. Doctors should be made aware of the legal implications of their participation in MDMs. A greater awareness of these responsibilities and improved team dynamics should optimize patient outcomes while limiting exposure of participants to legal liability. [source] Implementation of a short-stay programme after breast cancer surgery,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2010M. de Kok Background: Short-stay breast cancer surgery (24 h or day case) is not common practice in Europe. This before,after comparative study was carried out to test the feasibility of systematically implementing a care programme incorporating short-stay admission using strategies tailored to individual hospital needs, and to assess safety and facilitating factors. Methods: Patients with breast cancer from four Dutch hospitals participated. The intervention concerned the programme developed by the Maastricht University Medical Centre. This was implemented through local multidisciplinary meetings and educational outreach visits. Results: Of 421 eligible patients, 324 (77·0 per cent) gave consent to participate. The proportion of patients who had short-stay treatment increased from 45·3 per cent before to 82·2 per cent after implementation of the programme (P < 0·001). No increase was observed in the rate of complications, readmissions, reoperations or number of visits to the emergency department. Factors associated with an increased chance of short-stay treatment were: breast-conserving surgery, having children and being employed. Being aged over 64 years showed a trend towards a decreased chance. Conclusion: Introducing a care programme incorporating short stay following breast cancer surgery in four hospitals was feasible and safe. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | ||||||||||