Multidisciplinary Care in Cancer

What is Multidisciplinary Care in Cancer?

Multidisciplinary care (MDC) is an integrated team approach to Cancer in which medical and allied health care professionals consider all relevant treatment options and develop collaboratively an individual treatment plan for each patient.

What are the benefits of Multidisciplinary Care?

There is increasing evidence that MDC improves patient outcomes. The benefits of adopting a multidisciplinary approach include:

  • Improved patient care through the development of an agreed treatment plan
  • Provision of best practice through the adoption of evidence-based guidelines
  • Improved patient satisfaction with treatment
  • Improved mental well-being of health professional
  • Streamlining treatment pathways
  • Reduction in duplication of services
  • Improved access to possible clinical trials of new therapies
  • Increasing the timeliness of appropriate consultation and surgery and a shorter time frame from diagnosis to treatment.

Why is multidisciplinary care important?

MDC is a key mechanism for ensuring that all relevant disciplines contribute to decisions about the care of patients with cancer.

  • Evidence indicates that a team approach to cancer care can reduce mortality and improve quality of life for the patient.
  • There is also evidence that decisions made by a multidisciplinary team are more likely to be in accord with evidence-based guidelines than those made by individual clinicians.
  • Furthermore, patient satisfaction with treatment and the mental well-being of clinicians in a multidisciplinary team has been shown to be improved by a multidisciplinary approach to care.

What are the Principles of Multidisciplinary care?

  • A team approach, involving core disciplines integral to the provision of good care,
  • Including general practice, with input from other specialties as required
  • Communication among team members regarding treatment planning
  • Access to the full therapeutic range for all patients, regardless of geographical
  • Remoteness or size of institution
  • Provision of care in accordance with nationally agreed standards
  • Involvement of patients in decisions about their care

Team

S.NoPrinciple of careOutcome
A
The disciplines represented by the core team should minimally include surgery, oncology (radiation and medical oncology), pathology, radiology and supportive care. The individual patient’s general practitioner will be part of the team.

The core team is established and known.
B
In order to ensure that the patient has access to the full range of therapeutic options, the core team may be expanded or contracted to include services (may be off site), such as genetics, psychiatry, physiotherapy and nuclear medicine

Referral networks established for non-core team specialist services

Communication

S.No
Principle of care

Outcome
A. A communications framework should be established which supports and ensures interactive participation from all relevant team members at regular and dedicated case conference meetings.

Communication mechanisms are established to facilitate case discussion by all team members.
B. Multidisciplinary input should be considered for all patients with cancer, however, not all cases may ultimately necessitate team discussion.
A local protocol is established for deciding which cases may not require team discussion.

Full therapeutic range

S.No Principle of care
Outcome
A.
Geographical remoteness and/or small size of the institution delivering care should not be impediments to the delivery of multidisciplinary care for patients with cancer.

Systems are established for ensuring that all patients have access to all relevant services
B.
The members of the team should support the multidisciplinary approach to care by establishing collaborative working links.

Systems are established to support collaborative working links between team members.

Standards of care

S.No Principle of care Outcome
aAll clinicians involved in the management of patients with cancer should practice in accord with guideline recommendations.Local clinician data is consistent with national benchmarks
bThe treatment plan for a patient should consider individual patient circumstances and wishes.Local clinician data is consistent with national benchmarks
cDiscussion and decisions about treatment options should only be considered when all relevant patient results and information are availableFinal reports are available to all core team members before treatment planning
d In areas where the number of new cancers is small, formal collaborative links with larger units/centres should give support and foster expertise in the smaller unit Systems are established for the exchange of knowledge and expertise between larger and smaller caseload centres
e Maintenance of standards of best practice is supported by a number of activities which promote professional developmentSystems are established for the support of professional education activities

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