You are here

  • Home
  • Archive
  • Volume 9, Issue 11
  • Does multidisciplinary videoconferencing between a head-and-neck cancer centre and its partner hospital add value to their patient care and decision-making? A mixed-method evaluation

Article Text

Article menu

Download PDFPDF

XML
Oncology
Original research
Does multidisciplinary videoconferencing between a head-and-neck cancer centre and its partner hospital add value to their patient care and decision-making? A mixed-method evaluation
  1. Lidia S van Huizen1,2,
  2. Pieter Dijkstra3,
  3. Gyorgy B Halmos4,
  4. Johanna G M van den Hoek5,
  5. Klaas T van der Laan6,
  6. Oda B Wijers7,
  7. Kees Ahaus8,
  8. Jan G A M de Visscher9,10,
  9. Jan Roodenburg11
  1. 1 Quality and Patient Safety, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  2. 2 Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  3. 3 Centre for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  4. 4 Ear, Nose and Throat, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  5. 5 Radiotherapy, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  6. 6 Ear, Nose and Throat, Medical Center Leeuwarden, Leeuwarden, The Netherlands
  7. 7 Radiotherapeutic Institute Friesland, Leeuwarden, The Netherlands
  8. 8 Erasmus School of Health Policy & Management, Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands
  9. 9 Oral and Maxillofacial Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands
  10. 10 Oral and Maxillofacial Surgery/Oral Pathology, Free University Medical Center, Amsterdam, The Netherlands
  11. 11 Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Lidia S van Huizen; l.s.van.huizen{at}umcg.nl

Abstract

Objectives Given the difficulties in diagnosing and treating head-and-neck cancer, care is centralised in the Netherlands in eight head-and-neck cancer centres and six satellite regional hospitals as preferred partners. A requirement is that all patients of the partner should be discussed in a multidisciplinary team meeting (MDT) with the head-and-neck centre as part of a Dutch health policy rule. In this mixed-method study, we evaluate the value that the video-conferenced MDT adds to the MDTs in the care pathway, quantitative regarding recommendations given and qualitative in terms of benefits for the teams and the patient.

Design A sequential mixed-method study.

Setting One oncology centre and its partner in the Northern part of the Netherlands.

Participants Head-and-neck cancer specialists presenting patient cases during video-conferenced MDT over a period of 6 months. Semistructured interviews held with six medical specialists, three from the centre and three from the partner.

Primary and secondary outcome measures Percentage of cases in which recommendations were given on diagnostic and/or therapeutic plans during video-conferenced MDT.

Results In eight of the 336 patient cases presented (2%), specialists offered recommendations to the collaborating team (three given from centre to partner and five from partner to centre). Recommendations mainly consisted of alternative diagnostic modalities or treatment plans for a specific patient. Interviews revealed that specialists perceive added value in discussing complex cases because the other team offered a fresh perspective by hearing the case ‘as new’. The teams recognise the importance of keeping their medical viewpoints aligned, but the requirement (that the partner should discuss all patients) was seen as outdated.

Conclusions The added value of the video-conferenced MDT is small considering patient care, but the specialists recognised that it is important to keep their medical viewpoints aligned and that their patients benefit from the discussions on complex cases.

  • added value
  • collaborating teams
  • head-and-neck cancer
  • mixed method study
  • multidisciplinary team meetings (MDT)
  • videoconferencing (MeSH term)

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2018-028609

Statistics from Altmetric.com

    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.

    View Full Text

    Footnotes

    • Deceased Klaas T van der Laan died on May 4th 2019

    • Contributors LSvH was involved in the study design and concept, carried out the study, performed the statistical analysis and the analysis and interpretation of the data and drafted the manuscript. PD, KA, JGAMdV and JR, the supervisor, were involved in the study design and concept, analysis and interpretation of the data, and revision of the manuscript. JGAMdV and JR were involved in the coding of the interview quotations, together with LSvH. GBH, JGMvdH, KTvdL and ODW were involved in the acquisition of the data and the revision of the manuscript. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This prospective observational study on decision-making analysis was checked by the Medical Ethics Review Board of the UMCG (2016, ref. M16.194909), the Netherlands. They concluded that the study is not a ‘clinical research study with human subjects’ as meant in the Medical Research Involving Human Subject Act (WMO). The Dutch law requires also a privacy statement from the partner in the study, the Medical Centre Leeuwarden (2016, nWMO 187).

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

    • Data availability statement Data are available upon reasonable request.

    • Author note The University Medical Center Groningen is developing patient-centred care pathways for diverse patient groups including laws and regulations for quality and patient safety. LSvH and JR are working in cooperation with KA to research care pathway implementation in the Comprehensive Cancer Center Groningen and to develop quality and safety indicators, that is, process indicators that predict performance of care pathways and sustainable patient outcome.