An article published in the September 2009 issue of Incite regarding the impact of the Medicare Benefits Items 871 and 872 on cancer multidisciplinary teams.

Written by Mary L Fennell, Irene Prabhu Das, Steven Clauser, Nicholas Petrelli and Andrew Salner and published in Journal of the National Cancer Institute Monographs (2010;40:72–80), the abstract is as follows:

Quality cancer treatment depends upon careful coordination between multiple treatments and treatment providers, the exchange of technical information, and regular communication between all providers and physician disciplines involved in treatment. This article will examine a particular type of organizational structure purported to regularize and streamline the communication between multiple specialists and support services involved in cancer treatment: the multidisciplinary treatment care (MDC) team.

We present a targeted review of what is known about various types of MDC team structures and their impact on the quality of treatment care, and we outline a conceptual model of the connections between team context, structure, process, and performance and their subsequent effects on cancer treatment care processes and patient outcomes.

Finally, we will discuss future research directions to understand how MDC teams improve patient outcomes and how characteristics of team structure, culture, leadership, and context (organizational setting and local environment) contribute to optimal multidisciplinary cancer care.

pdf (468kb). This guide provides information on the implementation of multidisciplinary care.

Contents include:

• key principles of multidisciplinary care
• what is practically required to implement multidisciplinary care?
• what are the medico-legal implications of multidisciplinary care in an Australian context?

A number of guides, proformas and resources are available as downloadable PDFs from the NBOCC about multidisciplinary cancer care including:

• Multidisciplinary care for advanced disease: a guide for cancer health professionals
• Multidisciplinary care - what are the medico-legal implications?
• Information about the new MBS items for multidisciplinary cancer care
• Making multidisciplinary cancer care a reality: A National Breast Cancer Centre - Forum Series Report and Recommendations
• Multidisciplinary cancer care in Australia: A demonstration project in breast cancer
• Multidisciplinary meetings for cancer care
• Sustainability of multidisciplinary cancer care: A follow-up study to the National Demonstration Project in breast cancer
• Multidisciplinary cancer care in Australia.

Multidisciplinary care proformas are available as downloadable word documents including:

• MDC patient information sheet
• MDC meeting attendance
• MDC recommended treatment plan
• GP notification - outcome of MDC meeting

Practical information about claiming the MBS item for multidisciplinary care introduced in 2006.

These tools were developed to help hospital staff and Multidisciplinary Care Coordinators develop protocols for their multidisciplinary teams and meetings.

Tools include templates for meeting organisation, documentation, use of technology and the role of the coordinator.

The templates can be modified to suit each particular MDT.

This toolkit contains a comprehensive range of information, templates and checklists.

It covers:

• MDC fundamentals
• Setting up a Team
• Running a team

The resources have been funded by Cancer Australia as part of the Strengthening Cancer Care Initiative.

The Multidisciplinary Care Guidelines for Women with Breast Disease package describes best practice standards for health care professionals in providing coordinated, multidisciplinary care to women with breast disease. The package has a number of uses:

• for the rural GP and clinician who may not see many women with breast cancer - provides guidance on diagnostic and appropriate treatment options, referral options and how to best provide psychosocial support
• for the rural nurse and other allied health carers involved in the care of a woman with breast cancer - provides guidance to the different clinical pathways, referral options and how to best provide psychosocial support
• for the woman with breast cancer - describes what you can expect during your stay in hospital and immediately afterwards

Guidelines are included for:

• Care Planning For Management Of Breast Disease In Women
• Clinical Pathways
• Patient Information
• Pyschosocial Care

A range of Multidisciplinary Meeting procedural documents developed by Gipplsand Regional Integrated Cancer Services (GRICS) to support Multidisciplinary cancer teams.

Resources include:

• Meeting Facilitator Guidelines
• Rotating Chairperson Guidelines
• Meeting Protocols
• Meeting Terms of Reference

This toolkit was written to assist the development of multidisciplinary teams in all tumour streams.

The documents included in this toolkit are not intended to be prescriptive, but rather to prompt thought about the elements of best practice in multidisciplinary care.

The toolkit will assist in:

• developing team meeting protocols and establishing team practice;
• surveying existing meetings and ascertaining what might be necessary for newly forming teams;
• understanding how local multidisciplinary team meeting guidelines and protocols might appear and what they could contain;
• measuring the team‘s performance against the guidelines and protocols;
• developing or improving a multidisciplinary meeting agenda.

A range of publicly available, downloadable forms for use by multidisciplinary teams, including patient information, a patient request form and a patient consent kit.

The purpose of this Multidisciplinary Team Resource Guide is to provide some practical advice to be used by clinical teams who are setting up or already running an MDT meeting.

The Guide puts forward 12 questions based upon the requirements of the Manual of Cancer Standards and offers as answers some examples of service improvement case studies, resources and possible options to be considered.

Information for medical professionals about the various services offered and the vital role played in the multidisciplinary team by Allied Health carers for cancer patients at different stages of their journey; which may begin at diagnosis and treatment and continue intermittently as required to survivorship and palliative care.

A brief overview of the Allied Heath disciplines available at Peter Mac are included:

• Speech Pathology
• Physiotherapy
• Occupational Therapy
• Nutrition
• Social Work
• Music Therapy
• Psycho-Oncology
• Pastoral Care