UNASSIGNED:多学科团队(MDT)方法长期以来一直被认为是为乳腺癌患者提供高标准护理的最佳方法。随着越来越多的患者和越来越复杂的病例,MDT对时间和资源的压力越来越明显。因此,当地医院部门必须调整其MDT流程,以更好地简化讨论并优化效率。巴斯的皇家联合医院是英国的地区综合医院。每年大约有500名癌症患者接受治疗,MDT每周讨论约60名患者。
UNASSIGNED:为了改进我们的MDT会议流程并提高生产率,我们使用MicrosoftAccess™创建了一个简洁的MDT模板:让所有临床医生能够实时添加患者和信息。我们还分配了每周准备时间,因此高级临床医生确保所有患者在会议之前做好准备,并在可能的情况下预先填充结果和潜在结果。
UNASSIGNED:我们记录了在实施改变前后6次MDT会议期间讨论患者的时间。病例按病理类别分类以确定制剂变化后是否存在差异。总的来说,我们显著缩短了我们的平均MDT讨论时间(p=0.02).我们显着减少了术后恶性病例(p<0.0006)和预期良性核心活检病例(p<0.0047)的平均讨论时间,允许适当地重新分配时间来讨论更复杂的案件,讨论复杂放射学病例的时间显着增加(p<0.025)。
UNASSIGNED:我们提供了一种有效的方法来改善MDT会议的准备和演示,方法是确保每位患者在会议前做好适当的准备。这些简单案例的结果已经预先填充。这在会议中创造了额外的时间来讨论更复杂的临床病例,同时允许团队的所有成员在需要时讨论所有患者。
UNASSIGNED: The multidisciplinary team (
MDT) approach has long been considered the optimal way in which to deliver a high standard of care to patients with breast cancer. With a growing number of patients and ever-increasing complexity of cases, the strain on time and resource of the
MDT is becoming increasingly evident. It is therefore essential that local hospital departments adapt their
MDT processes to better streamline discussions and optimise efficiency. The Royal United Hospital in Bath is a district general hospital in the UK. Approximately 500 patients with cancers are treated annually, and the
MDT discusses approximately 60 patients per week.
UNASSIGNED: To improve our MDT meeting processes and increase productivity, we created a concise MDT template using Microsoft Access™: giving all clinicians the ability to add patients and information in real time. We also allocated weekly preparation time whereby a senior clinician ensured all patients were prepared prior to the meeting with results and potential outcomes prepopulated where possible.
UNASSIGNED: We recorded the time spent discussing patients during 6 MDT meetings before and after implementation of changes. Cases were classified by pathology category to determine if there were differences following the preparation changes. Overall, we significantly reduced our average
MDT discussion time (p=0.02). We significantly reduced average discussion time in postoperative malignant cases (p<0.0006) and expected benign core biopsy cases (p<0.0047), allowing appropriate redistribution of time towards discussion of more complex cases, reflected by the significant increase in time spent discussing complex radiology cases (p<0.025).
UNASSIGNED: We offer an effective method for improving the MDT meeting preparation and presentation by ensuring each patient is appropriately prepared prior to the meeting, and outcomes for those simple cases are already prepopulated. This creates additional time within the meeting to discuss more complex clinical cases while allowing all members of the team an opportunity to discuss all patients if needed.