• Jenny Harris, Cath Taylor, Nick Sevdalis, Rozh Jalil, and James S A Green.
• Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
• Int J Qual Health Care. 2016 Jun 1; 28 (3): 332-8.

ObjectiveTo develop a tool for independent observational assessment of cancer multidisciplinary team meetings (MDMs), and test criterion validity, inter-rater reliability/agreement and describe performance.DesignClinicians and experts in teamwork used a mixed-methods approach to develop and refine the tool. Study 1 observers rated pre-determined optimal/sub-optimal MDM film excerpts and Study 2 observers independently rated video-recordings of 10 MDMs.SettingStudy 2 included 10 cancer MDMs in England.ParticipantsTesting was undertaken by 13 health service staff and a clinical and non-clinical observer.InterventionNone.Main Outcome MeasuresTool development, validity, reliability/agreement and variability in MDT performance.ResultsStudy 1: Observers were able to discriminate between optimal and sub-optimal MDM performance (P ≤ 0.05). Study 2: Inter-rater reliability was good for 3/10 domains. Percentage of absolute agreement was high (≥80%) for 4/10 domains and percentage agreement within 1 point was high for 9/10 domains. Four MDTs performed well (scored 3+ in at least 8/10 domains), 5 MDTs performed well in 6-7 domains and 1 MDT performed well in only 4 domains. Leadership and chairing of the meeting, the organization and administration of the meeting, and clinical decision-making processes all varied significantly between MDMs (P ≤ 0.01).ConclusionsMDT-MOT demonstrated good criterion validity. Agreement between clinical and non-clinical observers (within one point on the scale) was high but this was inconsistent with reliability coefficients and warrants further investigation. If further validated MDT-MOT might provide a useful mechanism for the routine assessment of MDMs by the local workforce to drive improvements in MDT performance.© The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

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