Article Text

Download PDFPDF

Implementation of a lung cancer multidisciplinary team standardised template for reporting to general practitioners: a mixed-method study
  1. Nicole M Rankin1,
  2. Gemma K Collett1,
  3. Clare M Brown2,
  4. Tim J Shaw3,
  5. Kahren M White4,
  6. Philip J Beale5,
  7. Lyndal J Trevena6,
  8. Cleola Anderiesz7,
  9. David J Barnes2
  1. 1 Sydney Medical School, Sydney Catalyst Translational Cancer Research Centre, University of Sydney, Camperdown, New South Wales, Australia
  2. 2 Cancer Services, Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown, New South Wales, Australia
  3. 3 Research in Implementation Science and eHealth (RISe), Faculty of Health Sciences, University of Sydney, Camperdown, New South Wales, Australia
  4. 4 Cancer Institute NSW, Eveleigh, New South Wales, Australia
  5. 5 Cancer Services, Concord Repatriation and General Hospital Cancer Centre, Sydney Local Health District, Concord, New South Wales, Australia
  6. 6 Discipline of General Practice, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
  7. 7 Cancer Australia, Sydney, New South Wales, Australia
  1. Correspondence to Dr Nicole M Rankin; nicole.rankin{at}ctc.usyd.edu.au

Abstract

Objectives Few interventions have been designed that provide standardised information to primary care clinicians about the diagnostic and treatment recommendations resulting from cancer multidisciplinary team (MDT) (tumour board) meetings. This study aimed to develop, implement and evaluate a standardised template for lung cancer MDTs to provide clinical information and treatment recommendations to general practitioners (GPs). Specific objectives were to (1) evaluate template feasibility (acceptability, appropriateness and timeliness) with GPs and (2) document processes of preimplementation, implementation and evaluation within the MDT setting.

Design A mixed-method study design using structured interviews with GPs and qualitative documentation of project logs about implementation processes.

Setting Two hospitals in Central Sydney, New South Wales, Australia. Participants: 61 GPs evaluated the template. Two lung cancer MDTs, consisting of 33 clinicians, and eight researchers participated in template development and implementation strategy.

Results The MDT-reporting template appears to be a feasible way of providing clinical information to GPs following patient presentation at a lung cancer MDT meeting. Ninety-five per cent of GPs strongly agreed or agreed that the standardised template provided useful and relevant information, that it was received in a timely manner (90%) and that the information was easy to interpret and communicate to the patient (84%). Implementation process data show that the investment made in the preimplementation stage to integrate the template into standard work practices was a critical factor in successful implementation.

Conclusions This study demonstrates that it is feasible to provide lung cancer MDT treatment recommendations to GPs through implementation of a standardised template. A simple intervention, such as a standardised template, can help to address quality gaps and ensure that timely information is communicated between tertiary and primary care healthcare providers.

  • respiratory tract tumours
  • primary care
  • organisation of health services

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

View Full Text

Statistics from Altmetric.com

Footnotes

  • Contributors This study was proposed by DJB, TJS and NMR. NMR wrote the first draft of the manuscript and contributions were made by DJB, GKC, CMB, TJS, KMW, PJB, LJT and CA. DJB and PJB are clinical leaders at the participating sites. Project implementation was overseen by NMR and TJS. GKC undertook all project management tasks, including ethics and governance approvals, data collection and liaison with the Information Management and Technology Division. GKC and CMB were responsible for sending out templates and liaising with primary care practices with clinical oversight by DJB. Primary care clinical advice for template design was provided by LJT. KMW and CA provided strategic advice about jurisdictional cancer control issues. All authors approved the final draft of the manuscript.

  • Funding This work was supported by Cancer Australia as part of the NSW Collaboration of the Lung Cancer Demonstration Project (LCDP). The LCDP is an initiative of Cancer Australia, funded by the Australian Government.

  • Disclaimer The study funder, Cancer Australia, had no role in the study design; the collection, analysis and interpretation of data; or in the decision to submit the article for publication.

  • Competing interests None declared.

  • Ethics approval Ethics approval for this project was obtained from the Sydney Local Health District Human Research Ethics Committee (LNRSSA/15/RPAH/236) and site-specific local governance approvals were granted prior to project commencement.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.