Validation of team performance assessment of multidisciplinary tumor boards

Rozh Jalil; Waseem Akhter; Benjamin W Lamb; Cath Taylor; Jenny Harris; James S A Green; Nick Sevdalis

doi:10.1016/j.juro.2014.03.002

Validation of team performance assessment of multidisciplinary tumor boards

J Urol. 2014 Sep;192(3):891-8. doi: 10.1016/j.juro.2014.03.002. Epub 2014 Mar 11.

Authors

Rozh Jalil¹, Waseem Akhter², Benjamin W Lamb³, Cath Taylor⁴, Jenny Harris⁴, James S A Green⁵, Nick Sevdalis⁶

Affiliations

¹ Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Whipps Cross University Hospital, Barts Health National Health Service Trust, London, United Kingdom. Electronic address: r.jalil@imperial.ac.uk.
² Whipps Cross University Hospital, Barts Health National Health Service Trust, London, United Kingdom.
³ Department of Surgery and Cancer, Imperial College London, London, United Kingdom; Department of Urology, Lister Hospital, London, United Kingdom.
⁴ King's College London, London, United Kingdom.
⁵ Whipps Cross University Hospital, Barts Health National Health Service Trust, London, United Kingdom; Department of Health and Social Care, London Southbank University, London, United Kingdom.
⁶ Department of Surgery and Cancer, Imperial College London, London, United Kingdom.

PMID: 24631109
DOI: 10.1016/j.juro.2014.03.002

Abstract

Purpose: We construct validated the instrument to evaluate assessor learning curves and the feasibility and interrater reliability of MTB-MODe for assessing the decision making process using video recorded multidisciplinary tumor board meetings.

Materials and methods: Multidisciplinary tumor boards are becoming standard practice for managing cancer internationally but no standards have been agreed on to assess the efficacy of such teams. The MTB-MODe tool assesses the process of multidisciplinary tumor board decision making by standardized observation (1 to 5 anchored scales) of the quality of information presented at the multidisciplinary tumor board as well as board member contributions to the case review. We assessed 683 multidisciplinary tumor board case discussions using MTB-MODe in a multiphase study, including 332 cases (9 urology boards) by 1 urologist in vivo and 224 cases (6 urology boards) by 2 urologists in vivo. The instrument was refined and subsequently used to rate 127 video recorded case discussions (5 tumor types) by a total of 8 multidisciplinary tumor boards.

Results: Good interrater reliability was achieved in vivo and at the video recorded multidisciplinary tumor board meetings (ICC ≥0.70). MTB-MODe scores were higher in cases that resulted in a decision than in cases in which no decision was made (mean ± SD 2.54 ± 0.47 vs 2.02 ± 0.65, p ≤0.001).

Conclusions: A standardized method to assess the quality of multidisciplinary tumor board discussions can enhance the quality of cancer care and the ability of the boards to self-evaluate performance, thus, promoting good practice. Video recordings offer a feasible, reliable method of assessing how multidisciplinary tumor boards work.

Keywords: health care; interdisciplinary communication; neoplasms; quality assurance; urology; video recording.

Publication types

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

MeSH terms

Decision Making*
Feasibility Studies
Humans
Interdisciplinary Communication*
Learning Curve
Neoplasms* / therapy
Observer Variation
Patient Care Team / standards*
Prospective Studies
Quality Assurance, Health Care*
Video Recording