Laadun toteutuminen syövänhoidon MDT- ja syöpätiimitoiminnassa
Hytönen, Sari-Marja (2024)
2024
Kansanterveystieteen maisteriohjelma - Master's Programme in Public Health
Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences
This publication is copyrighted. Only for Your own personal use. Commercial use is prohibited.
Hyväksymispäivämäärä
2024-01-30
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202401081185
https://urn.fi/URN:NBN:fi:tuni-202401081185
Tiivistelmä
Cancer is one of the major public diseases in Finland, and its incidence is predicted to increase. The increase in cancer incidence and prevalence is driven by an ageing population, advances in diagnostics and improved cancer treatment outcomes. Cancer treatment is complex and influenced by the type and spread of cancer. With the increasing number of treatment options, planning, coordination and smooth implementation of treatment requires the cooperation of several different professionals. Multidisciplinary cancer care planning meetings (MDTs) have been established to implement multidisciplinary collaboration for supporting cancer diagnosis and treatment decisions.
This study investigated the implementation of the quality criteria of the Organization of European Cancer Institutes (OECI), an international network of cancer care quality assessment centres, in MDT activities and cancer team activities at Tampere University Hospital (Tays). The OECI has defined quality criteria for cancer care that cover MDT and cancer team activities. The OECI quality criteria define the participants in MDT meetings, their responsibilities, the equipment needed, the responsibility for implementing treatment recommendations, the deviations from treatment recommendations and their evaluation, the presentation of patients in MDT meetings and the inclusion of patients in clinical trials. The quality criteria should include regular monitoring of the smooth running of the processes for the cancer in question, patient access to treatment, implementation of treatment recommendations at MDT meetings and serious adverse effects of treatments.
The study was multi-methodological in nature. The literature consisted of the OECI quality criteria and previous research on MDT. The survey data consisted of questionnaires addressed to participants and facilitators of MDT meetings at Tays. The results of the quantitative survey data were reported as frequencies and percentages. A thematic analysis method was used to analyze the qualitative data. The quantitative and qualitative data were combined into thirteen themes.
The results showed that MDT meetings were attended by representatives of different specialties. Participants were generally well prepared for and able to attend MDT meetings. The equipment needed for MDT work was available. MDT meetings were perceived as an important learning environment for both professionals and students.
MDT meetings helped to harmonize care pathways and treatment approaches. A multi-professional decision-making process provides equal treatment and the best possible treatment options for cancer patients. However, the results of this study showed that not all new cancer patients are discussed at MDT meetings. The number of patients needing MDT presentation was perceived to be too high in relation to the time available and there was too little time to deal with more challenging patients. Shortcomings were identified in the availability of patient information. Patients' participation in clinical trials was rated fairly well. According to the survey, the cancer teams at the Tays Cancer Centre regularly review their operational processes. Weaknesses were observed in the monitoring of patients' access to treatment, compliance with treatment recommendations, treatment outcomes and adverse effects of treatment. Treatment pathways for cancer patients had been developed for most cancers.
The majority of participants in MDT meetings took part remotely. Remote meetings were perceived as efficient and systematic. They enabled better participation than physical meetings. They were perceived to reduce interaction and social interaction. They also allowed for better participation of students as the physical space did not limit the number of participants.
This study investigated the implementation of the quality criteria of the Organization of European Cancer Institutes (OECI), an international network of cancer care quality assessment centres, in MDT activities and cancer team activities at Tampere University Hospital (Tays). The OECI has defined quality criteria for cancer care that cover MDT and cancer team activities. The OECI quality criteria define the participants in MDT meetings, their responsibilities, the equipment needed, the responsibility for implementing treatment recommendations, the deviations from treatment recommendations and their evaluation, the presentation of patients in MDT meetings and the inclusion of patients in clinical trials. The quality criteria should include regular monitoring of the smooth running of the processes for the cancer in question, patient access to treatment, implementation of treatment recommendations at MDT meetings and serious adverse effects of treatments.
The study was multi-methodological in nature. The literature consisted of the OECI quality criteria and previous research on MDT. The survey data consisted of questionnaires addressed to participants and facilitators of MDT meetings at Tays. The results of the quantitative survey data were reported as frequencies and percentages. A thematic analysis method was used to analyze the qualitative data. The quantitative and qualitative data were combined into thirteen themes.
The results showed that MDT meetings were attended by representatives of different specialties. Participants were generally well prepared for and able to attend MDT meetings. The equipment needed for MDT work was available. MDT meetings were perceived as an important learning environment for both professionals and students.
MDT meetings helped to harmonize care pathways and treatment approaches. A multi-professional decision-making process provides equal treatment and the best possible treatment options for cancer patients. However, the results of this study showed that not all new cancer patients are discussed at MDT meetings. The number of patients needing MDT presentation was perceived to be too high in relation to the time available and there was too little time to deal with more challenging patients. Shortcomings were identified in the availability of patient information. Patients' participation in clinical trials was rated fairly well. According to the survey, the cancer teams at the Tays Cancer Centre regularly review their operational processes. Weaknesses were observed in the monitoring of patients' access to treatment, compliance with treatment recommendations, treatment outcomes and adverse effects of treatment. Treatment pathways for cancer patients had been developed for most cancers.
The majority of participants in MDT meetings took part remotely. Remote meetings were perceived as efficient and systematic. They enabled better participation than physical meetings. They were perceived to reduce interaction and social interaction. They also allowed for better participation of students as the physical space did not limit the number of participants.