Hartley Laura J, Evans Scott, Davies Mark A, Kelly Suzanne, Gregory Jonathan J
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.
J Multidiscip Healthc. 2021 Jan 15;14:115-123. doi: 10.2147/JMDH.S266014. eCollection 2021.
Cancer services are under increasing pressure to deliver waiting time targets. Our service has seen referral numbers increase to over 3000 per annum, with more than 80% coming from secondary care. In order to deliver a responsive service, the department has introduced a daily diagnostic multidisciplinary meeting (DMDT) with the aim being stratification of resources by directing rapid access to clinics and diagnostics to those felt to be at greatest risk of malignancy at the start of the pathway. It also aimed to improve communication with patients and referrers, consistency in decision making and deliver improved diagnostic turn-around times in a sustainable manner. An evaluation was undertaken to assess whether the introduction of the DMDT has improved the pathway, the primary endpoint being a reduction in time to definitive diagnosis (TTDD). Secondary endpoints included measurements of efficiency and whether there has been a reduction in variation in practice.
Retrospective access to a prospective database over a 1-month period before (2015) and after (2018) the intervention.
The introduction of the DMDT has led to a reduction in TTDD (7 days). The service also has an added benefit in reducing average total patient miles travelled over the course of diagnosis by 22.68 miles.
The introduction of a diagnostic MDT at the start of the pathway does lead to an improvement in service efficiency and a reduction in TTDD.
癌症服务在实现等待时间目标方面面临着越来越大的压力。我们的服务部门转诊数量已增至每年3000多例，其中超过80%来自二级医疗保健机构。为了提供响应迅速的服务，该部门引入了每日诊断多学科会议（DMDT），目的是通过将快速门诊和诊断资源导向那些在流程开始时被认为患恶性肿瘤风险最高的患者，从而实现资源分层。它还旨在改善与患者和转诊机构的沟通、决策的一致性，并以可持续的方式缩短诊断周转时间。开展了一项评估，以评估引入DMDT是否改善了流程，主要终点是确诊时间（TTDD）的缩短。次要终点包括效率测量以及实践差异是否有所减少。
回顾性查阅干预前（2015年）和干预后（2018年）1个月期间的前瞻性数据库。
引入DMDT导致TTDD缩短（7天）。该服务还有一个额外的好处，即诊断过程中患者平均总行程减少了22.68英里。
在流程开始时引入诊断多学科团队确实能提高服务效率并缩短TTDD。
