Biomaterial Database

Clinical audit of multidisciplinary care at a medium-sized hospital in Spain. 2014

Ana Ruiz-Casado, and María Jesús Ortega, and Ana Soria, and Héctor Cebolla

Medical Oncology Department, Hospital Universitario Puerta de Hierro-Majadahonda, C/ Joaquín Rodrigo 2, 28222, Majadahonda, Madrid, Spain. arcasado@salud.madrid.org.

BACKGROUND Multidisciplinary care is a key enabler in the provision of high quality care for cancer patients. Despite compelling evidence supporting their benefit to patients and for providers, multidisciplinary cancer conferences (MCC) are not universally occurring. Team composition of MCC reflects the multidisciplinary nature of the body. Lack of nursing input can have a negative impact on team decision making. The objective of this study was to evaluate multidisciplinary care and adherence to national recommendations at a medium-sized hospital through a clinical audit of cancer conferences and clinical records. METHODS A total of 77 multidisciplinary cancer conferences were visited and 496 electronic health records were reviewed. The regularity of meetings and multidisciplinary attendance were evaluated. Each electronic health record was checked to verify documented prospective discussion before any treatment was started. RESULTS Nine multidisciplinary teams meet on a weekly or biweekly basis at the hospital with an average number of ten people and six different specialties represented. Average duration of meetings was 46.8 min. Though most patients (64.5%) were discussed at some point at the relevant cancer conference, only 40% had a documented multidisciplinary team discussion prior to the first treatment. Pathological stage (pTNM) was documented in 53.6% of clinical records. CONCLUSIONS Nursing representatives should be included as usual attendees at cancer conferences. Prospective discussion of all cancer cases should be encouraged. Use of checklists and systematic collection of key information, specifically cancer staging, could improve clinical documentation in the electronic clinical record.

UI	MeSH Term	Description	Entries
D010348	Patient Care Team	Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.	Health Care Team,Interdisciplinary Health Team,Medical Care Team,Multidisciplinary Care Team,Multidisciplinary Health Team,Healthcare Team,Care Team, Health,Care Team, Medical,Care Team, Multidisciplinary,Care Team, Patient,Care Teams, Health,Care Teams, Patient,Health Care Teams,Health Team, Interdisciplinary,Health Team, Multidisciplinary,Healthcare Teams,Interdisciplinary Health Teams,Medical Care Teams,Multidisciplinary Care Teams,Multidisciplinary Health Teams,Patient Care Teams,Team, Health Care,Team, Healthcare,Team, Interdisciplinary Health,Team, Medical Care,Team, Multidisciplinary Care,Team, Multidisciplinary Health,Team, Patient Care,Teams, Interdisciplinary Health
D010818	Practice Patterns, Physicians'	Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.	Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D011379	Prognosis	A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.	Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011446	Prospective Studies	Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.	Prospective Study,Studies, Prospective,Study, Prospective
D011787	Quality of Health Care	The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.	Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D003657	Decision Making	The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.	Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D054869	Clinical Audit	A detailed review and evaluation of selected clinical records by qualified professional personnel to improve the quality of patient care and outcomes. The clinical audit was formally introduced in 1993 into the United Kingdom's National Health Service.	Audit, Clinical,Audits, Clinical,Clinical Audits