The MDT Flashcards
What is an MDT
‘A multidisciplinary approach involves drawing appropriately from multiple disciplines to explore problems outside of normal boundaries and reach solutions based on a new understanding of complex situations’
What does the cancer MDT make up
is made up of a variety of health professionals involved in treating and caring for patients, such as surgeons, clinicians, nurses and diagnosticians
What does the MDT do each week
Each week, the MDT meets to discuss individual patients’ cases and make treatment recommendations.
what is considered the gold standard for cancer patient management
the MDT
What does the MDT allow
All patients receive timely treatment and care from appropriately skilled professionals
Continuity of care
Ensure patients get adequate information and support
Facilitate communication between primary, secondary and tertiary care
Collection of reliable data – audit/research
Promote effective use of resources
Improve participants working lives
Give an example of how the MDT works
See new patient in clinic
Email MDT Coordinator to add patient to appropriate MDT
- What is the question for the MDT?
- What material needs to be reviewed?
Coordinator produces patient list for MDT each week
MDT runs Tuesday AM from 8-10
Attended by haem-onc consultants, pathologist, radiologists, clinical nurse specialists, radiation oncologist, junior staff
MDT proforma completed after the discussion and uploaded to patients notes
Aim to see the patient back in clinic following on from the MDT
What are the problems with the MDT
Increasing numbers of patients of increasing complexity requiring discussion
Increased workloads particularly for pathologists and radiologists to prepare for the meeting
Poor attendance
Having the right information available at the right time to make the correct decision
Inability to fulfil secondary roles
What are the specific dates of the two week waiting pathway
- 14 days from point of receipt of referral to the point where they are seen
- 62 day pathway – point of GP recipient to treatment
- 31 days pathway – point of decision to treatment
how many people are diagnosed in the two week waiting pathway with cancer
1 out of 10
- 9 out of 10 people are referred in this way are not diagnosed with cancer - have something else
Who is the specialist that the person will see after the two week waiting pathway
Often a surgery or a general physician depends what the symptom is
- Altered bowel habit
- Breast lump
- Haemoptysis/persistent cough
- Weight loss
when do you seen an oncologist
after you have been diagnosed with cancer
What happens in the consultation with the specialist
History
- Presenting complaint
- Past medical history (co-morbidity assessment)
Examination
Investigations
- Blood tests
- Biopsy
Scans
Follow-up appointment arranged to get results
Whose responsibility is it to give results
It is the responsibility of the investigating consultant to give the patient those results
How should you present results to the patient
Ensure results are reviewed prior to seeing patient in clinic
Contact relevant oncologist / haemato-oncologist and CNS in advance
- So you know what to tell the patient
- So you can tell them when they are going to be seen by the relevant specialist
What is important in communication with telling someone that they have cancer
Explore expectations
‘Warning shot’ – the scan had some bad news
Give information at the patient’s pace
Allow the patient time to react
Elicit concerns
