Aim
Following release of the Victorian cancer multidisciplinary team meeting quality framework [MDMQF] in 2018 this project aimed to compare practice between cancer multidisciplinary team meetings [MDMs] within and against host health services using agreed standards for the first time. Longitudinal auditing from this baseline will offer greater consistency in the way cancer MDMs are conducted and monitored, leading to benefits for participants, patients and carers. It will facilitate greater awareness of the minimum requirements for MDM within health services and influence practice change.
Methods
22 Health services reviewed 83 MDM meetings, using auditor interviews with key stakeholders, meeting observation, review of 1688 MDM patient MDM records against MDMQF minimum data, policy review and 1380 surveys completed by attendees. Results analysis was undertaken by health services to identify and develop projects to improve alignment of MDMs with MDMQF standards and make context-driven responses.
Results
Audited meetings were well attended by core membership specialties identified in Optimal Care Pathways [OCPs]. There were strong results for timely access of treatment teams and GPs to MDM recommendations. Trends in minimum data include low recording of non-biomedical data such as supportive care. Clinical trial consideration was poorly recorded. In both minimum data and surveying, consent had low practice recognition.
Conclusions
The benefits of the audit will be realised by host sites if they initiate routine auditing of MDMs against this project baseline. Five health services chose to audit more MDMs than specified with a further two auditing all their MDMs. Results for some minimum data showed marked variation between metropolitan and regional services. Data with low recognition across all settings suggested appropriate targets for state wide projects. There is a strong potential for MDMs to be utilised to measure key policy objectives such as compliance with Optimal Care Pathways, treatment management, and health outcomes.