Aim: To review cancer multidisciplinary meeting (MDM) practices and audit results of health services within the North Eastern Melbourne Integrated Cancer Service (NEMICS) region against the Victorian Cancer Multidisciplinary Team Meeting Quality Framework [1].
Methods: During September 2022 and May 2023, a mixed methods review of NEMICS MDMs was conducted. A desk-top review of past reported MDM performance against the eight quality standards and measures of the Quality Framework was undertaken. Current health services’ MDM policies, activity data, meeting practices, and billing methods were examined. 2021 Cancer Service Performance Indicator (CSPI) MDM audit results were analysed.
Results: Thirty- seven MDMs across the four health services were included in the review. None of the health services were compliant with all the Quality Framework’s standards. One of four health services had an MDM governance structure. Only 11% (n=4) of MDMs had up-to-date terms of reference (TOR) to define their purpose, membership, documentation, and evaluation requirements. Less than a quarter (22%, n=8) of MDMs had a membership that aligned with the relevant Optimal Care Pathway (OCP) [2]. MDM patient information was not available from any of the health services. Growth in patient presentations and activity demonstrated limited patient presentation time. The MDM software used in 3 of the 4 health services, did not capture the minimum MDM dataset. Current billing methods generate limited revenue. CSPI results indicate that none of the health services met targets such as relating to communicating the treatment plan to the patient's General Practitioner.
Conclusion: MDM practices across NEMICS member health services should align with the Quality Framework to facilitate best practice management of cancer patients. Health services should prioritise establishing and implementing robust MDM governance, meeting TOR, membership aligned with the OCPs, patient information, streamlining practices to address activity demands, capture of the minimum dataset, alternative revenue, and MDM communications.