Implementation of a lung cancer multidisciplinary team standardised template for reporting to general practitioners: a mixed-method study

• Published in: BMJ open Vol. 7; no. 12; p. e018629
• Main Authors: Rankin, Nicole M, Collett, Gemma K, Brown, Clare M, Shaw, Tim J, White, Kahren M, Beale, Philip J, Trevena, Lyndal J, Anderiesz, Cleola, Barnes, David J
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.12.2017; BMJ Publishing Group
• Subjects: Adult; Aged; Aged, 80 and over; Best practice; Breast cancer; Cancer therapies; Chemotherapy; Documentation - standards; Family physicians; Female; General Practitioners; Humans; Interdisciplinary Communication; Intervention; Lung cancer; Lung Neoplasms - therapy; Male; Medical diagnosis; Medical referrals; Medical research; Medical screening; Meetings; Middle Aged; Mixed methods research; New South Wales; Oncology; Palliative care; Patient Care Team - organization & administration; Primary care; Quality Assurance, Health Care - standards; Self evaluation; Surveys and Questionnaires; Teaching hospitals; Thoracic surgery; Young Adult; United Kingdom > UK; Australia; primary care; organisation of health services; respiratory tract tumours
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2017-018629

ObjectivesFew interventions have been designed that provide standardised information to primary care clinicians about the diagnostic and treatment recommendations resulting from cancer multidisciplinary team (MDT) (tumour board) meetings. This study aimed to develop, implement and evaluate a standardised template for lung cancer MDTs to provide clinical information and treatment recommendations to general practitioners (GPs). Specific objectives were to (1) evaluate template feasibility (acceptability, appropriateness and timeliness) with GPs and (2) document processes of preimplementation, implementation and evaluation within the MDT setting.DesignA mixed-method study design using structured interviews with GPs and qualitative documentation of project logs about implementation processes.SettingTwo hospitals in Central Sydney, New South Wales, Australia. Participants: 61 GPs evaluated the template. Two lung cancer MDTs, consisting of 33 clinicians, and eight researchers participated in template development and implementation strategy.ResultsThe MDT-reporting template appears to be a feasible way of providing clinical information to GPs following patient presentation at a lung cancer MDT meeting. Ninety-five per cent of GPs strongly agreed or agreed that the standardised template provided useful and relevant information, that it was received in a timely manner (90%) and that the information was easy to interpret and communicate to the patient (84%). Implementation process data show that the investment made in the preimplementation stage to integrate the template into standard work practices was a critical factor in successful implementation.ConclusionsThis study demonstrates that it is feasible to provide lung cancer MDT treatment recommendations to GPs through implementation of a standardised template. A simple intervention, such as a standardised template, can help to address quality gaps and ensure that timely information is communicated between tertiary and primary care healthcare providers.