886741
886741.
Med J Aust. 2015 Feb 16;202(3):144-7. doi: 10.5694/mja14.00768.
To develop a peer-review model for assessment and quality improvement of cancer multidisciplinary teams (MDTs) and qualitatively assess its feasibility and acceptability in Australia.
DESIGN, SETTING AND PARTICIPANTS: A peer-review methodology was developed, based on the United Kingdom's National Health Service peer-review model and a comprehensive literature review. This was pilot tested in three mature MDTs in different settings. Semi-structured interviews were conducted between December 2012 and July 2013 with all five peer reviewers and 17 MDT members. Thematic analysis was undertaken using a framework approach.
Peer reviewers and MDT members found the process reasonable, constructive and useful; however, those involved in the preparation for the review found it time-consuming. Most MDT members considered the final report accurate and reflective of their service. Recommendations in the report were met with mixed reactions: several MDT members perceived some recommendations to be particularly relevant, while others viewed the same recommendations as impractical or of limited value. Many participants were unsure if recommendations would be fully implemented. The majority saw value in the process and expressed support for its implementation locally and nationally; however, feedback suggests the most appropriate format is yet to be established.
Peer review of cancer MDTs is feasible and acceptable. We describe valuable lessons learnt and recognise that further development of the proposed peer-review model and national benchmarking of MDTs against established outcome measures is required if this process is to be widely implemented.
制定一种同行评议模式,用于评估和改进癌症多学科团队(MDT),并在澳大利亚定性评估其可行性和可接受性。
设计、地点和参与者:基于英国国民保健制度的同行评议模式和全面的文献综述,开发了一种同行评议方法。该方法在不同环境下的三个成熟 MDT 中进行了试点测试。2012 年 12 月至 2013 年 7 月,对所有五名同行评议员和 17 名 MDT 成员进行了半结构化访谈。采用框架方法进行主题分析。
同行评议员和 MDT 成员认为该过程合理、建设性和有用;然而,那些参与审查准备的人认为这很耗时。大多数 MDT 成员认为最终报告准确反映了他们的服务。报告中的建议反应不一:一些 MDT 成员认为一些建议特别相关,而另一些成员则认为这些建议不切实际或价值有限。许多参与者不确定建议是否会得到全面实施。大多数人认为该过程有价值,并表示支持在当地和全国范围内实施;然而,反馈表明,最适当的格式尚未确定。
癌症 MDT 的同行评议是可行和可接受的。我们描述了宝贵的经验教训,并认识到,如果要广泛实施这一过程,则需要进一步开发拟议的同行评议模式,并对 MDT 进行国家基准测试,以与既定的结果衡量标准进行比较。