Wright F C, Lookhong N, Urbach D, Davis D, McLeod R S, Gagliardi A R
Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Ann Surg Oncol. 2009 Oct;16(10):2731-7. doi: 10.1245/s10434-009-0639-6. Epub 2009 Aug 7.
Cancer care is complex and multimodal therapy is now considered the standard of care. Multidisciplinary cancer conferences (MCCs) offer a venue to prospectively discuss cancer patients and plan treatment. MCCs are believed to improve patient outcomes and consequently have been internationally adopted. The purpose of this study was to describe the prevalence of MCCs in Ontario and identify individual and organizational barriers to their adoption.
A cross-sectional, mailed questionnaire of general surgeons in Ontario, Canada who care for patients with cancer was used to assess prevalence, and organizational and individual barriers to MCC implementation. Responses were summarized overall, by hospital, and by academic status.
The response rate was 44.2% (170/385). Respondents worked at 57 unique hospitals, of which 29 (52%) were reported to have MCCs, including all academic hospitals (7/7) and 22 of 50 (44%) community hospitals. Forty-nine MCCs were reported at 29 hospitals. MCCs occurred weekly at academic centers and biweekly or monthly at community hospitals. Few MCCs (28%) had a designated coordinator. Surgeons perceived that MCCs helped them to incorporate multidisciplinary opinions into their patient care plans, improved collegiality, and provided opportunity for continuing professional development.
Despite the perceived benefits expressed by respondents, administrative support for MCCs may be minimal. In particular, surgeons at community hospitals may have limited access to multidisciplinary patient care planning. This information will be utilized to shape a provincial strategy for implementing MCCs. However, further research is required to understand barriers and enablers to establish and maintain MCCs, especially in community practice.
癌症护理十分复杂,多模式治疗如今被视为护理标准。多学科癌症会议(MCCs)提供了一个前瞻性讨论癌症患者并规划治疗方案的场所。人们认为MCCs能改善患者预后,因此已在国际上得到采用。本研究的目的是描述安大略省MCCs的普及情况,并确定其采用过程中的个人和组织障碍。
采用横断面邮寄问卷的方式,对加拿大安大略省负责治疗癌症患者的普通外科医生进行调查,以评估MCCs的普及情况以及实施过程中的组织和个人障碍。总体、按医院以及按学术地位对回复进行了总结。
回复率为44.2%(170/385)。受访者在57家不同的医院工作,其中29家(52%)报告设有MCCs,包括所有学术医院(7/7)以及50家社区医院中的22家(44%)。29家医院共报告了49次MCCs。学术中心的MCCs每周举行一次,社区医院则每两周或每月举行一次。很少有MCCs(28%)设有指定协调员。外科医生认为MCCs有助于他们将多学科意见纳入患者护理计划,改善合作关系,并提供持续专业发展的机会。
尽管受访者表示了MCCs的益处,但对其的行政支持可能很少。特别是,社区医院的外科医生在多学科患者护理规划方面的机会可能有限。这些信息将用于制定省级MCCs实施策略。然而,需要进一步研究以了解建立和维持MCCs的障碍和促进因素,尤其是在社区实践中。