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优化多学科团队会议的质量:叙述性评论。

Optimising the quality of multidisciplinary team meetings: A narrative review.

机构信息

University of Melbourne, Melbourne, Victoria, Australia.

Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.

出版信息

Cancer Med. 2022 May;11(9):1965-1971. doi: 10.1002/cam4.4432. Epub 2022 Mar 7.

Abstract

BACKGROUND

Understanding of factors that contribute to implementation of effective cancer multidisciplinary team meetings (MDMs) is still limited. Published literature on the effect of teamwork function, leadership roles, decision-making processes and structural components on the quality of MDMs was reviewed and synthesised.

METHODS

In this paper, a MEDLINE review (September 2020) was performed to assess clinical decision-making in the context of MDM discussions.

RESULTS

Twenty-nine eligible studies were included. Six studies addressed the infrastructural aspects of MDMs. Nine studies used either qualitative or mixed method approach to develop and validate observational tools to assess the quality of MDMs. Seven studies used qualitative approaches to explore the opinions of MDM members on factors that impact on the effectiveness of MDMs. Five studies used validated observational tools to observe and assess the effectiveness of MDMs. One prospective study explored the relationship between quality of information presented at MDMs and ability of MDM members to make clinical decisions. The final study prospectively tested the ability of a multicomponent intervention to improve decision-making processes within MDMs.

CONCLUSIONS

A broad range of factors including teamwork, leadership, case complexity, decision-making processes and availability of patient information were identified to impact the quality of MDMs. Evidence currently available largely focuses on the development of tools to identify factors in need of improvement to optimise MDMs. Robust research is required to identify the factors that are demonstrated to enhance MDM quality which can then aid the standardisation of how MDMs are conducted.

摘要

背景

对促成有效的癌症多学科团队会议(MDMs)实施的因素的理解仍然有限。对团队合作功能、领导角色、决策过程和结构组成部分对 MDM 质量的影响的文献进行了回顾和综合分析。

方法

本文对 MEDLINE 进行了回顾(2020 年 9 月),以评估 MDM 讨论背景下的临床决策。

结果

纳入了 29 项符合条件的研究。6 项研究涉及 MDM 的基础设施方面。9 项研究使用定性或混合方法来开发和验证观察工具,以评估 MDM 的质量。7 项研究使用定性方法探讨 MDM 成员对影响 MDM 有效性的因素的看法。5 项研究使用经过验证的观察工具来观察和评估 MDM 的有效性。一项前瞻性研究探讨了 MDM 上呈现的信息质量与 MDM 成员做出临床决策的能力之间的关系。最后一项研究前瞻性地测试了一种多组分干预措施对改善 MDM 内决策过程的能力。

结论

确定了广泛的因素,包括团队合作、领导、病例复杂性、决策过程和患者信息的可用性,这些因素会影响 MDM 的质量。目前现有的证据主要集中在开发识别需要改进的因素的工具,以优化 MDM。需要进行强有力的研究,以确定那些被证明可以提高 MDM 质量的因素,从而有助于规范 MDM 的实施方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e6ea/9089217/4b0e18ad4c2f/CAM4-11-1965-g001.jpg

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