Implementation rates of uro-oncology multi-disciplinary meeting decisions.

Abstract

INTRODUCTION/BACKGROUND: A patient newly diagnosed with cancer will need input from a range of medical specialties and allied health professionals. Such multi-disciplinary care (MDC) allows clinicians with a range of expertise to collaborate in patient care. This allows balanced decision making and cross-pollination of knowledge. The aim of this study was to assess the implementation of the consensus plans made at multi-disciplinary meetings (MDM), which underpins the effectiveness of MDC. METHODS: A retrospective review was performed of all patients discussed at the uro-oncology MDM at our institution between 1 January to 30 June 2015. Hospital databases were used to retrieve all urological oncologic procedures during the enrolment period and rates of referral for MDM discussion following a new histological diagnosis of malignancy, categorized by tumour type, were assessed. Patient records were interrogated to confirm MDM plan implementation, with the primary outcomes examined being completion of MDM plan within 3 months and factors preventing implementation. RESULTS: During the enrolment period, from 291 uro-oncological procedures 240 yielded malignant histology which 160 (67%) were discussed at the MDM. Overall, 202 patients, including 32 females were discussed at the uro-oncology MDM. MDM consensus plans were implemented in 184 (91.1%) patients. Reasons for deviation from the MDM plan included delay in care, patient deterioration or comorbidities, patient preference, consultant decision, loss to follow up and change in patient scenario due to additional new information from re-staging. CONCLUSION: The MDM is increasingly important in the care of uro-oncology patients, with about two-thirds of new diagnoses currently captured. Currently, there appear to be few barriers to the implementation of consensus plans, with nearly all patients undergoing the recommended management.