Exploring Clinical Decision-Making among the Uro-oncology Multidisciplinary Team: A Qualitative Study

Blake Askelin; Alicia Hind; Catherine Paterson

doi:10.1016/j.soncn.2023.151447

Exploring Clinical Decision-Making among the Uro-oncology Multidisciplinary Team: A Qualitative Study

Semin Oncol Nurs. 2023 Aug;39(4):151447. doi: 10.1016/j.soncn.2023.151447. Epub 2023 May 12.

Authors

Blake Askelin¹, Alicia Hind², Catherine Paterson³

Affiliations

¹ Faculty of Health, and School of Nursing, Midwifery and Public Health, University of Canberra, Bruce ACT, Australia.
² Faculty of Health; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group; and School of Nursing, Midwifery and Public Health, University of Canberra, Bruce ACT, Australia.
³ Faculty of Health; Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group; Professor, School of Nursing, Midwifery and Public Health, University of Canberra, Bruce ACT, Australia; Canberra Health Services & ACT Health, SYNERGY Nursing & Midwifery Research Centre, Canberra Hospital, Australia; and Robert Gordon University, Aberdeen, Scotland, UK. Electronic address: catherine.paterson@canberra.edu.au.

PMID: 37179175
DOI: 10.1016/j.soncn.2023.151447

Abstract

Objective: The aim of this qualitative study was to understand the clinical decision-making process among the genitourinary oncology (GU) multidisciplinary team (MDT) and how patients are engaged in the process.

Data sources: A qualitative descriptive study design was conducted and has been reported according to the Consolidated Criteria for Reporting Qualitative Studies (COREQ). Members of the GU MDT were recruited from a metropolitan tertiary hospital and cancer regional center in Australia serving a population of 550,000. Semistructured interviews were conducted, and the audiorecordings were transcribed; an inductive thematic analysis was used to provide insight from multiple perspectives.

Conclusion: Three themes emerged: (1) the role and scope of the uro-oncology MDT, (2) lack of person-centered clinical decision-making, and (3) the barriers and facilitators. Amid the COVID-19 pandemic, the MDT discussions transitioned to virtual application, which was found to be convenient and efficient and improved attendance. The GU cancer MDT had a prominent biomedical focus that lacked person-centered considerations. Additional research is needed to explore how person-centered outcomes can be incorporated into the clinical decision-making process.

Implication for nursing practice: The GU MDT is increasingly important in the care of uro-oncology patients. There appears to be barriers to the implementation of person-centered discussions in the MDT. The effective delivery of multidisciplinary care is contingent on an appropriate mechanism for collaborative communication between all MDT members and patients given the limited involvement of the patient in the MDT itself.

Keywords: Board meeting; Cancer care genitourinary; Multidisciplinary; Patient referral; Person-centered care; virtual discussion.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Clinical Decision-Making
Decision Making
Humans
Neoplasms*
Pandemics
Patient Care Team