caa a22 4500 445338768 CHVBK 20180317142805.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1245/s10434-011-1773-5 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1773-5 Quality Improvement in Multidisciplinary Cancer Teams: An Investigation of Teamwork and Clinical Decision-Making and Cross-Validation of Assessments [Elektronische Daten] [B. Lamb, N. Sevdalis, H. Mostafid, C. Vincent, J. Green] Purpose: Teamworking and clinical decision-making are important in multidisciplinary cancer teams (MDTs). Our objective is to assess the quality of information presentation and MDT members' contribution to decision-making via expert observation and self-report, aiming to cross-validate the two methods and assess the insight of MDT members into their own team performance. Materials and Methods: Behaviors were scored using (i) a validated observational tool employing Likert scales with objective anchors, and (ii) a 29-question online self-report tool. Data were collected from observation of 164 cases in five MDTs, and 47 surveys from MDT members (response rate 70%). Presentation of information (case history, radiological, pathological, comorbidities, psychosocial, and patients' views) and quality of contribution to decision-making of MDT members (surgeons, oncologists, radiologists, pathologists, nurses, and MDT coordinators) were analyzed via descriptive statistics and the Jonckheere-Terpstra test. Correlation between observational and self-report assessments was assessed with Spearman's correlations. Results: Quality of information presentation: Case histories and radiology information rated highest; patients' views and comorbidities/psychosocial issues rated lowest (observed: Z=14.80, P≤0.001; self-report: Z=3.70, P<0.001). Contribution to decision-making: Surgeons and oncologists rated highest, nurses and MDT coordinators rated lowest, and others in between (observed: Z=20.00, P≤0.001; self-report: Z=8.10, P<0.001). Correlations between observational and self-report assessments: Median Spearman's rho=0.74 (range=0.66-0.91; P<0.05). Conclusions: The quality of teamworking and clinical decision-making in MDTs can reliably be assessed using observational and self-report metrics. MDT members have good insight into their own team performance. Such robust assessment methods could provide the basis of a toolkit for MDT team evaluation and improvement. Society of Surgical Oncology, 2011 Lamb B. Department of Surgery and Cancer, Imperial College London, 5th Floor Medical School Building, St. Mary's Hospital, London, UK aut Sevdalis N. Department of Surgery and Cancer, Imperial College London, 5th Floor Medical School Building, St. Mary's Hospital, London, UK aut Mostafid H. Department of Urology, Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, UK aut Vincent C. Department of Surgery and Cancer, Imperial College London, 5th Floor Medical School Building, St. Mary's Hospital, London, UK aut Green J. Department of Urology, Whipps Cross University Hospital, London, UK aut Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3535-3543 1068-9265 18:13<3535 2011 18 10434 https://doi.org/10.1245/s10434-011-1773-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1773-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lamb B. Department of Surgery and Cancer, Imperial College London, 5th Floor Medical School Building, St. Mary's Hospital, London, UK aut NATIONALLICENCE 700 1- Sevdalis N. Department of Surgery and Cancer, Imperial College London, 5th Floor Medical School Building, St. Mary's Hospital, London, UK aut NATIONALLICENCE 700 1- Mostafid H. Department of Urology, Basingstoke and North Hampshire NHS Foundation Trust, Basingstoke, UK aut NATIONALLICENCE 700 1- Vincent C. Department of Surgery and Cancer, Imperial College London, 5th Floor Medical School Building, St. Mary's Hospital, London, UK aut NATIONALLICENCE 700 1- Green J. Department of Urology, Whipps Cross University Hospital, London, UK aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/13(2011-12-01), 3535-3543 1068-9265 18:13<3535 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer