Soukup Tayana, Lamb Benjamin W, Arora Sonal, Darzi Ara, Sevdalis Nick, Green James Sa
Health Service and Population Research Department, Centre for Implementation Science, King's College London, London, UK.
Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
J Multidiscip Healthc. 2018 Jan 19;11:49-61. doi: 10.2147/JMDH.S117945. eCollection 2018.
In many health care systems globally, cancer care is driven by multidisciplinary cancer teams (MDTs). A large number of studies in the past few years and across different literature have been performed to better understand how these teams work and how they manage patient care. The aim of our literature review is to synthesize current scientific and clinical understanding on cancer MDTs and their organization; this, in turn, should provide an up-to-date summary of the current knowledge that those planning or leading cancer services can use as a guide for service implementation or improvement. We describe the characteristics of an effective MDT and factors that influence how these teams work. A range of factors pertaining to teamwork, availability of patient information, leadership, team and meeting management, and workload can affect how well MDTs are implemented within patient care. We also review how to assess and improve these teams. We present a range of instruments designed to be used with cancer MDTs - including observational tools, self-assessments, and checklists. We conclude with a practical outline of what appears to be the best practices to implement (Dos) and practices to avoid (Don'ts) when setting up MDT-driven cancer care.
在全球许多医疗保健系统中,癌症护理由多学科癌症团队(MDT)推动。在过去几年中,针对不同文献开展了大量研究,以更好地了解这些团队的运作方式以及他们如何管理患者护理。我们进行文献综述的目的是综合当前关于癌症多学科团队及其组织的科学和临床认识;反过来,这应该为那些规划或领导癌症服务的人员提供最新的知识总结,他们可以将其用作服务实施或改进的指南。我们描述了有效多学科团队的特征以及影响这些团队工作方式的因素。一系列与团队合作、患者信息可用性、领导力、团队及会议管理和工作量相关的因素会影响多学科团队在患者护理中的实施效果。我们还综述了如何评估和改进这些团队。我们介绍了一系列旨在与癌症多学科团队配合使用的工具——包括观察工具、自我评估和检查表。我们最后给出了一个实用大纲,内容是在建立由多学科团队驱动的癌症护理时似乎应实施的最佳做法(该做之事)和应避免的做法(不该做之事)。