• B W Lamb, N Sevdalis, J Benn, C Vincent, and J S A Green.
• Centre for Patient Safety and Service Quality, Department of Surgery and Cancer, Imperial College London, 5th Floor Medical School Building, St. Mary's Hospital, London, W2 1PG, UK. benjamin.lamb@imperial.ac.uk
• Ann. Surg. Oncol. 2013 Mar 1; 20 (3): 715-22.

BackgroundAnecdotally, organizational factors appear to have an effect on the quality of decision-making in the multidisciplinary team (MDT) meeting. We assess the effect of the number of team-members present, number and order of cases, and the timing of meetings on the process of decision-making in MDT meetings.MethodsBetween December 2009 and January 2010, data were prospectively collected on treatment decisions, meeting characteristics, quality of information, and teamworking for all cases discussed at a London-based MDT meeting. Variables measured using a validated assessment tool (MDT MODe) and correlational analyses were performed.ResultsTreatment decisions were reached in 254 of 298 (85%) cases. Cases toward the end of meetings were associated with lower rates of decision-making, information quality, and teamworking (r = -0.15 to -0.37). Increased number of cases per meeting and team members in attendance were associated with better information and teamworking (r = 0.29-0.43). More time per case was associated with improved teamworking (r = 0.16). A positive correlation was obtained between ability to reach decisions and improved information and teamworking (r = 0.36-0.54; all P ≤ 0.001).ConclusionsOrganizational factors related to the structure of the MDT meeting are associated with variation in the likelihood of reaching a treatment decision. Further research is required to establish causation and to modify such factors in order to improve the quality of cancer care.

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