Abstract 1729P
Background
MDTs are a central institution of decision making in oncological centres. Good recommendations are comprehensible, follow guidelines, are consistent to following treatment and responsibility for this case must be made explicit. In order to constantly improve our performance, we examined key factors influencing MDT recommendations. After this analysis, structural intervention was performed to exclude the main factors influencing our performance negatively. Here we report the outcomes and results of this intervention.
Methods
After examining our MDT performance retrospectively in 488 tumor board decisions, we changed the registration process, including definition of required input for aspects of patient history and the protocol of our MDT for GI cancers. We also made sure that personal responsibility was provided for case presentation as well as for further action. Analysis of MDT recommendation after this intervention was performed using the same questionnaire as in the first analysis prospectively in 488 tumor board presentations and decisions of the complete following year. We correlated input-factors of MDT registration to output-factors defining reasonable MDT recommendations. Simple comparison was performed using chi-square testing between individual factors, group of factors and outcome variables.
Results
Following our intervention, we measured significant increase of all factors considered to be most influential for good recommendations (Table).
Table: 1729P
Input factor | Before (%) | After (%) | p-value |
Presence of core team members | 54,7 | 62,8 | < .0001 |
Clear indications of patient wishes | 85,96 | 96,93 | < .0001 |
Complete case information | 80,12 | 89,55 | < .0001 |
Information of thorough discussion | 5,7 | 17,2 | .095 |
Good recommendations | 65,16 | 84,63 | < .0001 |
Conclusions
Oncological treatment is often based on MDT recommendations. Therefore, high quality of MDT must be ensured, transparency and understandability of the protocol must be clear and responsibility for further action needs to be addressed. We hereby demonstrate that changing infrastructural factors in registration and protocol of recommendations lead to improved tumor board decisions.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
L. Galonska.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
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