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The aim of the Multidisciplinary Team is to improve the
outcomes and experience of patients with cancer.
MDT working ensures that all appropriate patients are discussed
by all relevant professionals with all relevant information, this ensures
that patients receive the best possible care.
A study by Haward R. Amir Z.Borril C. et al (1) of
breast MDT meetings established that MDT working is positively related
to a range of measures of effectiveness, including quality of clinical
care. It also emphasised the importance of the distinction between
management and administration- which needs a clear team lead, and clinical
decision making- which is most effective in MDT meetings with a shared
leadership style. The findings of this study also indicate that working
in teams may be beneficial to the mental health of members.
Risk management and clinical governance are also supported
through MDT working. For successful clinical governance we must capitalise
on the diversity of skills in the NHS and transform groups of people
from different disciplines into effective working teams.
Moss et al (1998) (2) suggest
that a patient with lung cancer will have contact with about 20 professionals
including a consultant. While it is the consultant who usually discusses
the diagnosis and treatment options with the patient the decisions
about care cannot be made without the contribution of the others.
 Questions
to ask your teams
- Is the MDT a real team or a group of individual people coming
together for a meeting?
- Does your MDT leave status at the door?
- Does everyone participate and contribute?
- Does open and honest discussion take place? Where it is acceptable
to be wrong.
- How good is the MDT decision making? Do you know?
- Does the MDT evaluate its effectiveness?
- Does the MDT value everyone’s input? Does everyone have a
voice?
- Is everyone who attends involved in looking at ways to improve
services?
- Does the MDT work in collaboration, co-operation and how does it
resolve disagreements?
- What learning and sharing comes from the MDT?
- Has the MDT grasped the reality of how to function effectively?
- Does the MDT have a shared vision for the ideal patients journey?
Remember, it is not only clinicians who impact on
the effectiveness and efficiency of services. Even
in well-run services ways can be found to get even better. Don’t
be complacent. Remember good teams
don’t just happen. You have to work to make them good.
(1) Haward R, Amir Z, Borril C
et al.2003 Breast cancer teams; the impact of constitution, workload,
and methods of operation on their effectiveness. British Journal
of Cancer Vol 89 P. 15-22
(2) Moss,F., Garside.P., Dawson,S.,(1998)
Organisational change: the key to quality improvement. Quality
in Healthcare 7:S1-S2
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