scholarly journals Establishing a video Multidisciplinary Team meeting between Cameroon, Central Africa, and Leeds, UK, childhood cancer services

2021 ◽  
Author(s):  
Bernard Wirndzem Njodzeka ◽  
Glenn Afungchwi ◽  
Francine Kouya ◽  
Susan Picton ◽  
Roly Squire ◽  
...  
Keyword(s):  
Decision Making ◽  
Professional Education ◽  
Multidisciplinary Team ◽  
Team Building ◽  
Central Africa ◽  
Team Members ◽  
Geographically Dispersed ◽  
Cancer Services ◽  
Relapsed Disease ◽  
The Uk

Abstract Background and aims Multidisciplinary team (MDT) meetings provide a regular, structured meeting of a core group of professionals to provide expert decision-making in individual patient care. We describe our experiences in establishing a virtual pediatric oncology MDT between twinning partners in Cameroon (4 hospitals) and the UK. Methods Monthly video conferencing MDT meetings were established in March 2019, initially using Google meet then using Zoom platforms. Case details were circulated using formal proformas. Standard operating procedures were outlined for the MDT conduct. Results There have been 269 discussions of 201 patients in 21 meetings. Patients have been varied in age (up to 24 years). Eighty-seven (43.3%) patients had NHL, 16 (8.0%) had Wilms tumour, 20 (10.0%) had Acute Lymphoblastic Leukaemia, 19 (9.5%) had Retinoblastoma and 59 (29.4%) had other malignancies. Four of the patients did not have a malignancy. The majority of patients had stage 3 (51, 45.1%) or stage 4 (59, 52.2%). Nine patients had relapsed disease. Core team members reported positive benefits from the MDT, including defining goals of care, shared decision making, professional education and team-building. Conclusions Virtual MDT meetings between geographically dispersed teams are possible and have proved particularly valuable during the COVID-19 pandemic when in-person visits are not permitted. Cancer treatment cannot be done in isolation; the regular MDT meetings have paved the way for informed care through regular consultancy.

scholarly journals Multidisciplinary team meetings in community mental health: a systematic review of their functions

2016 ◽  
Vol 21 (2) ◽  
pp. 119-140 ◽  
Author(s):  
Caoimhe Nic a Bháird ◽  
Penny Xanthopoulou ◽  
Georgia Black ◽  
Susan Michie ◽  
Nora Pashayan ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Community Mental Health ◽  
Multidisciplinary Team ◽  
Community Mental Health Services ◽  
Content Type ◽  
Team Members ◽  
Team Meetings ◽  
Unwarranted Variation ◽  
The Uk

Purpose – Previous research has identified a need for greater clarity regarding the functions of multidisciplinary team (MDT) meetings in UK community mental health services. The purpose of this paper is to identify the functions of these meetings by systematically reviewing both primary research and academic discussion papers. Design/methodology/approach – Papers relating to adult community mental health teams (CMHTs) in the UK and published between September 1999 and February 2014 were reviewed and appraised using NICE quality checklists. The search was broad in scope to include both general CMHTs and specialist CMHTs such as early intervention psychosis services and forensic mental health teams. A thematic synthesis of the findings was performed to develop an overarching thematic framework of the reported functions of MDT meetings. Findings – None of the 4,046 studies identified directly investigated the functions of MDT meetings. However, 49 mentioned functions in passing. These functions were categorised into four thematic domains: discussing the care of individual patients, teamwork, team management and learning and development. Several papers reported a lack of clarity about the purpose of MDT meetings and the roles of different team members which hindered effective collaboration. Practical implications – Without clearly agreed objectives for MDT meetings, monitoring their effectiveness is problematic. Unwarranted variation in their functioning may undermine the quality of care. Originality/value – This is the first systematic review to investigate the functions of CMHT MDT meetings in the UK. The findings highlight a need for empirical research to establish how MDT meetings are being used so that their effectiveness can be understood, monitored and evaluated.

Multidisciplinary team working: is it both holistic and effective?

2004 ◽  
Vol 14 (2) ◽  
pp. 210-211 ◽  
Author(s):  
H. Jefferies ◽  
K. K. Chan
Keyword(s):  
Multidisciplinary Team ◽  
Clinical Management ◽  
Tertiary Care ◽  
Medical Model ◽  
Holistic Care ◽  
Disease Trajectory ◽  
Team Working ◽  
Cancer Services ◽  
The Uk ◽  
Seamless Service

Multidisciplinary team (MDT) working has been endorsed as the main mechanism to ensure truly holistic care for patients and a seamless service for patients throughout their disease trajectory and across the boundaries of primary, secondary, and tertiary care. However the effectiveness of each team needs to be continually evaluated to ensure that all the relevant disciplines are able to participate in the clinical management of patients. This article describes the work of the Cancer Services Collaborative at the Birmingham Women's hospital in the UK in promoting the development of a holistic MDT in parallel with the medical model.

scholarly journals Perceived Interpersonal and Institutional Challenges to Patient Advocacy in Clinical Nursing Practice: A Qualitative Study from Ghana / Interpersonelle ind Institutionelle Herausforderungen für Die Rolle Als Patientenfürsprecher/-In Aus Sicht Der Pflege: Eine Qualitative Studie Aus Ghana

2020 ◽  
Vol 7 (1) ◽  
pp. 45-52
Author(s):  
Grace Dadzie ◽  
Lydia Aziato
Keyword(s):  
Decision Making ◽  
Multidisciplinary Team ◽  
Interprofessional Collaboration ◽  
Negative Attitude ◽  
Institutional Support ◽  
Patient Advocacy ◽  
Team Members ◽  
Patient Advocates ◽  
Training Programmes ◽  
Institutional Challenges

AbstractBackgroundNurses often speak on patients’ behalf and safeguard their safety through their advocacy role. However, some challenges like the negative attitude of team members and lack of institutional support often hamper this role. These challenges have not been well studied in the Ghanaian context.AimThis study explores the perceived environmental challenges to patient advocacy among nurses in Ghana.SettingThe study was conducted at a regional hospital in Ghana.ParticipantsParticipants were nurses or midwives working in the hospital.MethodsA qualitative exploratory descriptive design was employed in the study of 15 purposively sampled participants. Participants were interviewed individually and data were analysed using content analysis.FindingsThe study revealed interpersonal challenges and institutional challenges to patient advocacy, such as hierarchical nurse–doctor relationships and ineffective multidisciplinary team, time constraints and lack of institutional support. Nurses often failed to advocate because they did not want to risk conflict with doctors. Limited interprofessional interaction, suspicion and resentment in the multidisciplinary team negatively affected nurses’ role as patient advocates. Inadequate curricular support for patient advocacy and lack of support for training programmes or to undertake further studies were the additional challenges.ConclusionPatient advocacy could be a stressful role for nurses; thus, efforts to strengthen teamwork and increase nurse involvement in hospital decision-making are required.Implications for nursing and health policyThe findings could influence hospital management policies to enhance stronger interprofessional collaboration, increase opportunities for professional advancement for nurses and nurses’ inclusion in decision-making.

Cancer treatment and causation

Clinical Risk ◽  
2007 ◽  
Vol 13 (4) ◽  
pp. 151-153
Author(s):  
Victor Barley
Keyword(s):  
Cancer Treatment ◽  
Histological Examination ◽  
Multidisciplinary Team ◽  
Basic Knowledge ◽  
Delay In Diagnosis ◽  
Patients With Cancer ◽  
Cancer Services ◽  
Diagnosis Of Cancer ◽  
The Uk ◽  
Medicolegal Issues

A series of three articles exploring medicolegal issues arising out of the detection and treatment of cancer. The treatment of cancer involves several different specialists and, in the majority of cancer services in the UK, patients with cancer are seen by a multidisciplinary team. After the diagnosis of cancer has been confirmed by histological examination which shows the type and grade of the cancer, further tests are usually needed to determine the extent and spread of the tumour, i.e. the stage. Many cancers have already spread before the diagnosis can be made, even if the metastases cannot be detected at the time of the initial diagnosis. Many cancers are therefore not curable even though there is no indication of spread from the initial tests. Therefore, an unwarranted delay in diagnosis may not result in a poorer prognosis, although it is clearly important to give treatment at the earliest opportunity to reduce the possibility of spread. This article outlines the basic knowledge required by a clinical negligence practitioner when considering a potential oncology claim.

scholarly journals 1618 Improving the Clinic Experience for Surgical Patients Visiting the Melanoma Multidisciplinary Team Clinic at Guy’s and St Thomas’ NHS Foundation Trust

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Harbour ◽  
D Dhillon ◽  
J L C Geh
Keyword(s):  
Patient Satisfaction ◽  
Plastic Surgery ◽  
Multidisciplinary Team ◽  
Waiting Times ◽  
Surgical Patient ◽  
Post Intervention ◽  
Patient Satisfaction Score ◽  
Team Members ◽  
The Uk ◽  
Patient Waiting

Abstract Aim The incidence of malignant melanoma has been increasing in the UK over the last decade. Effective melanoma management requires a multidisciplinary team (MDT) approach, often involving dermatologists, oncologists, radiologists, histopathologists, skin cancer nurse specialists and plastic surgeons. Patient waiting times at our melanoma MDT clinic at the St John’s Institute of Dermatology at Guy’s Hospital, London had anecdotally been reported as excessive, specifically for same-day ‘in-clinic referrals’ from dermatology to plastic surgery. We aimed to ascertain the reasons for the delay and implement changes to improve patient satisfaction in the clinic. Method A patient satisfaction questionnaire was devised, measuring satisfaction on a numerical scale of 1 (unsatisfied) to 5 (very satisfied) in addition to a clinic staff perception questionnaire on patient satisfaction. Lack of instruction from staff after the dermatology appointment was identified as the predominant factor contributing towards waiting delays to the plastic surgery clinic. This led us to highlight and educate the issue to all team members involved and create a system whereby patients re-reported to the administrative staff after their dermatology appointment to be re-entered into the system. Results As a result of this, the mean surgical patient satisfaction score, pre-intervention of 3.83, improved to 4.50 post-intervention. Similarly, mean scores from staff assessing perception of how well the clinic ran and patient waiting times also increased. Conclusions The introduction of a new patient in-clinic referral protocol and increased staff education of the issue has improved both patient and staff satisfaction within the clinic’s health care provision.

scholarly journals The Value Of Webcams For Virtual Teams

2012 ◽  
Vol 16 (2) ◽  
pp. 161 ◽  
Author(s):  
Joel Olson ◽  
Frank Appunn ◽  
Kimberly Walters ◽  
Lynn Grinnell ◽  
Chad McAllister
Keyword(s):  
Virtual Teams ◽  
Low Cost ◽  
Team Building ◽  
Exploratory Research ◽  
Team Process ◽  
Team Members ◽  
Geographically Dispersed ◽  
Use Of Technology ◽  
The Rich ◽  
Rich Content

The latest low-cost technology solutions provide practical and reliable video options form standard personal computers using the Internet. By adding video to an established and geographically dispersed team process, this exploratory research tries to establish the experience of participants and perceived effectiveness of the team. Building on the literature, this qualitative research performs a content analysis design on a text transcription of weekly audio logs from participants. This approach analyzes the rich content of team members to discover the relevance of differing elements within trust, technology, and effectiveness find support. By understanding the influences of adding video to teams, leaders, and managers should be able to make informed decisions regarding the adoption of video for each participant. The attitude evolution regarding the use of technology over a period of six weeks provides further considerations for deployment.

NSCLC: Integrating the “Yale model shared decision-making solution” into the practice setting.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7054-7054
Author(s):  
Kerin B. Adelson ◽  
Roy S. Herbst ◽  
Patricia Peterson ◽  
Michele Ingram ◽  
Brant J. Oliver ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Team Building ◽  
Role Play ◽  
Risk Tolerance ◽  
Shared Decision ◽  
Post Intervention ◽  
Decision Style ◽  
Team Members ◽  
National Quality

7054 Background: Lung cancer patients are faced with treatment choices that involve complex decisions that can be preference-sensitive. In 2017 the National Quality Forum initiated a “Call to Action” to integrate shared decision-making (SDM) processes into practice in which clinicians and patients work together to make healthcare decisions that align with what matters most to patients. Projects In Knowledge, @Point of Care, Dartmouth and Yale collaborated to develop a pilot educational initiative to address and improve patient-centered care and SDM processes in the institutional cancer-care setting. Methods: Training materials co-developed for the Yale NSCLC team members (oncologists, nurses/NPs, social worker) address SDM, Checkpoint Inhibitor Therapy in NSCLC, and clinician-patient role play methods for implementing SDM in treatment discussions/decisions. Qualitative interview and observational methods were used to assess improved SDM performance by the multidisciplinary Yale NSCLC team by comparing baseline pre-intervention to post-intervention interviews and rating observed performance on case study role-play scenarios. Following the training and assessments, a focus group that included all team members was conducted to assess the acceptability, feasibility, and repeatability of the program and to inform future education. Results: Training empowered all Yale NSCLC team members to show pre- to post-education improvement in SDM (34% to 88%). Areas of greatest improvement: 1) providing reasonable treatment options to patients (+58%); 2) determining decision style preference – to what extent a patient wants to participate in the treatment decision process with their clinician (+76%); 3) determining patients’ risk tolerance regarding treatments that may be more efficacious but may have more side effects (+77); and 4) determining patients’ goals/preferences (+88%). Conclusions: Educational training improved SDM skills by all Yale NSCLC team members, which can lead to improved clinician-patient decision-making and patient-centric care. The training process also facilitated team building and encouraged ongoing participation in SDM.

Food for Thought

2012 ◽  
Vol 21 (2) ◽  
pp. 68-72 ◽  
Author(s):  
Caryn Easterling
Keyword(s):  
Multidisciplinary Team ◽  
Clinical History ◽  
Team Members ◽  
Speech Language Pathologist ◽  
Expected Outcome

Our professional American Speech-Language-Hearing Association (ASHA) guidelines state, if a speech-language pathologist suspects on the basis of the clinical history that there may be an esophageal disorder contributing to the patient's dysphagia, then “An esophageal screening can be incorporated into most [videofluoroscopic swallowing studies, or] VFSS” (ASHA, 2004). However, the esophageal screen has not been defined by ASHA or by the American College of Radiology. This “Food for Thought” column suggests deglutologists work together to determine the procedure and expected outcome for the esophageal screen so that there is acceptance and consensus among the multidisciplinary team members who evaluate patients with dysphagia.

How multidisciplinary are multidisciplinary case reviews in cancer care? Feasibility analysis of a theory-driven team decision-making fidelity framework

2019 ◽  
Author(s):  
Tayana Soukup ◽  
Ged Murtagh ◽  
Ben W Lamb ◽  
James Green ◽  
Nick Sevdalis
Keyword(s):  
Decision Making ◽  
Cancer Care ◽  
Recent Decade ◽  
Individual Case ◽  
Multidisciplinary Teams ◽  
Final Decision ◽  
Political Climate ◽  
Implementation Framework ◽  
Feasibility Evaluation ◽  
The Uk

Background Multidisciplinary teams (MDTs) are a standard cancer care policy in many countries worldwide. Despite an increase in research in a recent decade on MDTs and their care planning meetings, the implementation of MDT-driven decision-making (fidelity) remains unstudied. We report a feasibility evaluation of a novel method for assessing cancer MDT decision-making fidelity. We used an observational protocol to assess (1) the degree to which MDTs adhere to the stages of group decision-making as per the ‘Orientation-Discussion-Decision-Implementation’ framework, and (2) the degree of multidisciplinarity underpinning individual case reviews in the meetings. MethodsThis is a prospective observational study. Breast, colorectal and gynaecological cancer MDTs in the Greater London and Derbyshire (United Kingdom) areas were video recorded over 12-weekly meetings encompassing 822 case reviews. Data were coded and analysed using frequency counts.Results Eight interaction formats during case reviews were identified. case reviews were not always multi-disciplinary: only 8% of overall reviews involved all five clinical disciplines present, and 38% included four of five. The majority of case reviews (i.e. 54%) took place between two (25%) or three (29%) disciplines only. Surgeons (83%) and oncologists (8%) most consistently engaged in all stages of decision-making. While all patients put forward for MDT review were actually reviewed, a small percentage of them (4%) either bypassed the orientation (case presentation) and went straight into discussing the patient, or they did not articulate the final decision to the entire team (8%). Conclusions Assessing fidelity of MDT decision-making at the point of their weekly meetings is feasible. We found that despite being a set policy, case reviews are not entirely MDT-driven. We discuss implications in relation to the current eco-political climate, and the quality and safety of care. Our findings are in line with the current national initiatives in the UK on streamlining MDT meetings, and could help decide how to re-organise them to be most efficient.

Collaborative Action Research In Academic Administration

2019 ◽  
Vol 8 (3) ◽  
pp. 227-252
Author(s):  
Bradley C. Thompson
Keyword(s):  
Decision Making ◽  
Action Research ◽  
Collaborative Action Research ◽  
Team Members ◽  
Academic Administration ◽  
Leadership Culture ◽  
Collaborative Action ◽  
Working Together ◽  
Upper Level ◽  
Action Process

This research involved a study exploring the changes in an academic institution expressed through decision-making in a shifting leadership culture. Prior to the study, the school was heavily entrenched in authoritarian and centralized decision-making, but as upper-level administrators were exposed to the concept of collaborative action research, they began making decisions through a reflection and action process. Changing assumptions and attitudes were observed and recorded through interviews at the end of the research period. The research team engaged in sixteen weekly cycles of reflection and action based on an agenda they mutually agreed to and through an analysis of post-research interviews, weekly planning meetings, discussions, and reflection and action cycles. Findings revealed experiences centering around the issues of:  The nature of collaboration- it created discomfort, it created a sense of teamwork, it created difficulty.  The change of environment in the process- team members began to respect each other more, and the process became more enjoyable.  The freedom and change in the process- freedom to voice opinions and to actively listen, the use of experience to lead elsewhere in the school.  How issues of power are better understood by working together- the former process was less collaborative, politics will always be part of the process. As a result of this study, members have started using this decision-making methodology in other areas of administration.

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