Kinnear Ned, Smith Riley, Hennessey Derek B, Bolton Damien, Sengupta Shomik
Department of Urology, Austin Health, Heidelberg, Vic., Australia.
Department of Surgery, University of Melbourne, Heidelberg, Vic., Australia.
BJU Int. 2017 Nov;120 Suppl 3:15-20. doi: 10.1111/bju.13892. Epub 2017 Sep 14.
To assess implementation rates of the consensus plans made at the uro-oncology multidisciplinary meeting (MDM) of an Australian tertiary centre, and analyse obstacles to implementation.
A retrospective review was performed of all patients discussed at the uro-oncology MDM at our institution between 1 January and 30 June 2015. Rates of referral for MDM discussion after a new histological diagnosis of malignancy, categorised by tumour type, were assessed. Patient records were interrogated to confirm MDM plan implementation, with the outcomes examined being completion of MDM plan within 3 months and factors preventing implementation.
During the enrolment period, from 291 uro-oncological procedures, 240 yielded malignant histology of which 160 (67%) were discussed at the MDM. Overall, 202 patients, including 32 females, were discussed at the uro-oncology MDM. MDM consensus plans were implemented in 184 (91.1%) patients. Reasons for deviation from the MDM plan included delay in care, patient deterioration or comorbidities, patient preference, consultant decision, loss to follow-up, and change in patient scenario due to additional new information.
The MDM is increasingly important in the care of uro-oncology patients, with about two-thirds of new diagnoses currently captured. There appear to be few barriers to the implementation of consensus plans, with nearly all patients undergoing the recommended management.
评估澳大利亚一家三级中心泌尿肿瘤多学科会议(MDM)制定的共识计划的实施率,并分析实施过程中的障碍。
对2015年1月1日至6月30日期间在我们机构的泌尿肿瘤MDM上讨论的所有患者进行回顾性研究。评估新的恶性组织学诊断后因肿瘤类型分类的MDM讨论转诊率。查阅患者记录以确认MDM计划的实施情况,检查的结果包括在3个月内完成MDM计划以及阻碍实施的因素。
在入组期间,291例泌尿肿瘤手术中有240例产生恶性组织学结果,其中160例(67%)在MDM上进行了讨论。总体而言,泌尿肿瘤MDM讨论了202例患者,包括32名女性。184例(91.1%)患者实施了MDM共识计划。偏离MDM计划的原因包括护理延迟、患者病情恶化或合并症、患者偏好、会诊医生决定、失访以及由于新信息导致患者情况发生变化。
MDM在泌尿肿瘤患者的护理中日益重要,目前约三分之二的新诊断病例被纳入。共识计划的实施似乎几乎没有障碍,几乎所有患者都接受了推荐的治疗。