Multidisciplinary team meeting Chairs' attitudes and perceived facilitators, barriers and ideal improvements to meeting functionality: A qualitative study

Klay Lamprell; Renuka Chittajallu; Gaston Arnolda; Bróna Nic Giolla Easpaig; Geoff P Delaney; Winston Liauw; Ian Olver; Jeffrey Braithwaite

doi:10.1111/ajco.14077

Multidisciplinary team meeting Chairs' attitudes and perceived facilitators, barriers and ideal improvements to meeting functionality: A qualitative study

Asia Pac J Clin Oncol. 2024 May 16. doi: 10.1111/ajco.14077. Online ahead of print.

Authors

Klay Lamprell¹, Renuka Chittajallu^{2

3}, Gaston Arnolda¹, Bróna Nic Giolla Easpaig^{1

4}, Geoff P Delaney^{5

6}, Winston Liauw^{7

8}, Ian Olver⁹, Jeffrey Braithwaite¹

Affiliations

¹ Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia.
² Medical Oncology, Riverina Cancer Care Centre, Wagga Wagga, Australia.
³ Medical Oncology, GenesisCare, Kingswood, Australia.
⁴ School of Nursing, Charles Darwin University, Darwin, Australia.
⁵ South-Western Sydney Clinical School, University of New South Wales, Sydney, Australia.
⁶ Radiation Oncology, Liverpool Hospital, Liverpool, Australia.
⁷ St. George Cancer Care Centre, St. George Hospital, Kogarah, Australia.
⁸ St. George Hospital Clinical School, University of New South Wales, Sydney, Australia.
⁹ School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.

PMID: 38757440
DOI: 10.1111/ajco.14077

Abstract

Aim: Oncology care provision by multidisciplinary teams (MDTs) is widely acknowledged as best practice. Formal team meetings, led by chairpersons, coordinate decisions on diagnosis, staging, treatment planning, and review. This study addresses a gap in meeting Chairs' perspectives on factors affecting functionality across the meeting cycle, from pre-meeting patient list triage to post-meeting dissemination of recommendations.

Methods: Semi-structured interviews were conducted in person with Chairs within two urban geographical regions in New South Wales, Australia as part of a larger project. Though the population of oncology MDT Chairs in Australia is small, the richness and depth of data from nine Chairs were considered to be valuable knowledge in support of extant literature on meeting functionality. An integrated deductive-inductive approach was applied to data analysis.

Results: Perceived facilitators, barriers, and ideals relating to pre-meeting, in-meeting, and post-meeting functionality were identified across five pre-determined analytic categories: the team; meeting infrastructure; meeting organization and logistics; patient-centered clinical decision-making, and; team governance. Key barriers included inadequate information technology, limited support staff, and lack of dedicated time for Chair duties. Corresponding facilitators included robust Information Technology infrastructure and support, provision of clinically knowledgeable MDT meeting coordinators, and formal employment recognition of Chairs' responsibilities and skill sets.

Conclusion: Chairs across various tumor streams develop workarounds to overcome barriers and ensure quality meeting outcomes. With more robust support they could enhance value by sharing evidence, conducting audits, and engaging in research. The findings highlight the need for healthcare systems to support tumor stream clinical networks by allocating greater resources to prioritize multidisciplinary meetings and cancer care decision-making.

Keywords: hospital; interdisciplinary communication; leadership; multidisciplinary teams; oncology service; teamwork.

Grants and funding

APP1135048/National Health and Medical Research Council