Use Of Multidisciplinary Teams Research Articles

Understanding Multidisciplinary-team Practice in Developing Home Assessment Tools: A Systematic Review

As widely used instruments to identify risk factors and lay out preliminary plans of how to improve the built environment, home assessment tools play an important role in the process of modifying homes for older adults. Developed by a variety of disciplines and tailored to meet various needs, home assessment tools focus on features in homes and how they meet or hinder an older person’s ability to accomplish tasks — in other words, person-environment fit. Based on a comprehensive review of ten evidence-based home assessment tools identified by researchers at the USC Leonard Davis School of Gerontology and the National Council on Aging, we found that a common assessment strategy is the use of multidisciplinary teams (MDTs) in developing and testing the assessment tools to ensure the reliability vs validity of different home modification programs. To understand the nature of MDT practice and derive a set of generalizable protocols for developing person-centered home assessment tools, we conducted a systematic analysis of the ten evidence-based home assessment tools and 41 peer-reviewed journal papers about how the tools were developed, used, and modified. In addition, we applied the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) to examine the use of MDTs in developing the tools and carrying out the programs. Based on our analysis, we propose a set of preliminary protocols for developing home assessment tools and a logic model for conducting person-centered home modification programs.

The cancer multidisciplinary team meeting: in need of change? History, challenges and future perspectives.

Two decades since their inception, multidisciplinary teams (MDTs) are widely regarded as the 'gold standard' of cancer care delivery. Benefits of MDT working include improved patient outcomes, adherence to guidelines, and even economic benefits. Benefits to MDT members have also been demonstrated. An increasing body of evidence supports the use of MDTs and provides guidance on best practise. The system of MDTs in cancer care has come under increasing pressure of late, due to the increasing incidence of cancer, the popularity of MDT working, and financial pressures. This pressure has resulted in recommendations by national bodies to implement streamlining to reduce workload and improve efficiency. In the present review we examine the historical evidence for MDT working, and the scientific developments that dictate best practise. We also explore how streamlining can be safely and effectively undertaken. Finally, we discuss the future of MDT working including the integration of artificial intelligence and decision support systems and propose a new model for improving patient centredness.

Multidisciplinary Care of BRAF-Mutant Stage III Melanoma: A Physicians Perspective Review.

Prognosis among patients with stage III melanoma can vary widely depending on the risk of disease relapse. Therefore, it is vital to optimize patient care through accurate diagnosis and staging as well as thoughtful treatment planning. A multidisciplinary team (MDT) approach, which involves active collaboration among physician specialists across a patient's disease journey, has been increasingly adopted as the standard of care for treatment of a variety of cancers, including melanoma. This review provides an overview of MDT care principles for patients with BRAF‐mutant–positive, stage III cutaneous melanoma and summarizes current literature, clinical experiences, and institutional best practices. Therapeutic goals from dermatologic, surgical, and medical oncologist perspectives regarding MDT care throughout a patient's disease course are discussed. Additionally, the role of each specialty's involvement in testing for predictive biomarkers at relevant time points to facilitate informed treatment decisions is discussed. Last, instances of successful MDT treatment of other cancers and key lessons to optimize MDT patient care in cutaneous melanoma are provided. Several aspects of MDT patient care are considered vital, such as the importance of staging via pathological examination and imaging, biomarker testing, and interdisciplinary physician and patient engagement throughout the course of treatment. Use of MDTs has the potential to improve patient care in cutaneous melanoma by improving the speed and accuracy of diagnosis, implementing a personalized treatment plan early on, and being proactive in adverse event management. Physician perspectives described in this review may lead to better outcomes, quality of life, and overall patient satisfaction.Implications for PracticeAs more cancer therapies emerge, it is critical to optimize patient care and treatment planning. The multidisciplinary team (MDT) approach, which involves active collaboration among specialists, has led to encouraging survival results in multiple cancer types. As MDT care becomes more widely adopted in the treatment of melanoma, accurate diagnosis and staging are important, as clinical outcomes for stage III disease vary widely by substage. Because ~50% of melanomas harbor BRAF mutations, testing is important for an informed treatment decision. Interdisciplinary physician‐patient engagement throughout the course of treatment can improve comorbidity and adverse event management to optimize patients' treatment journeys.

A randomized-control trial testing the impact of a multidisciplinary team response to older adult maltreatment

ABSTRACTForensic center multidisciplinary teams (MDTs) have emerged to address older adult maltreatment; however, little research is available on this approach. The current study employed a randomized-control design to test the impact of a victim-focused, forensic center MDT relative to usual care (UC) on older adult victim and criminal justice outcomes. Cases of abuse, neglect, and/or financial exploitation involving a perpetrator in a position of trust were randomly assigned to MDT or UC. Outcomes were assessed via interviews with older adult victims, system-based advocates' surveys, and administrative data. According to system-based advocates, MDT had a better prognosis, higher across-agency coordination, and more types of engaged services relative to UC. Administrative data indicated low rates of APS case openings and prosecution. Findings provide support for continued use of MDTs following older adult maltreatment and highlight difficulties engaging older adults given the complex social and material circumstances often related to maltreatment.

The effectiveness of lung cancer MDT and the role of respiratory physicians.

There is an increasing trend for the use of multi-disciplinary teams (MDT) in the management of complex medical conditions. The latter may include various cancers, including lung cancer. However, the use of MDT is not restricted to cancer management, but may include complex conditions like diabetes and other non-malignant disorders. There is an increasing trend to use MDT in the investigation and management of patients with suspected or proven lung cancer. This review examines the evidence that supports the efficacy, or otherwise, of lung cancer management in a MDT as opposed to individual care, who should be a member of a lung cancer MDT, and the specific role of the respiratory physician in a lung cancer MDT. Although it may seem to make common sense to manage lung cancer in a MDT setting, there is actually little in the way of high quality data to support this concept. The logistic and ethical difficulties in researching this issue are highlighted in this review.

What is the role of the multidisciplinary team in the management of urinary incontinence?

Multidisciplinary teams (MDT) are a well-established part of service provision and clinical care in the UK. In 2013, the National Institute for Health and Care Excellence (NICE) Urinary Incontinence guideline recommended that MDT review should be mandatory before invasive therapy is offered to all patients with stress urinary incontinence (SUI) and overactive bladder (OAB). Currently, there is no evidence in the literature regarding the use of MDTs in urogynaecology. The aim of this paper is to assess the potential benefits and disadvantages of the creation of routine MDT meetings for the management of urinary incontinence.

Multidisciplinary Team Approaches to the Investigation and Resolution of Child Abuse and Neglect: A National Survey

Many benefits have been attributed to multidisciplinary team (MDT) approaches used in the investigation and resolution of child abuse and neglect. Yet more than a decade has passed since the nature and characteristics of MDTs have been examined. Findings presented in this article suggest that MDTs vary according to configuration, legislation, function, composition, and training. Current approaches are distinctive when compared with approaches found in previous national surveys. Specifically, the past 10 years have been characterized by the creation of a variety of MDT configurations, a dramatic expansion of legislation permitting or mandating MDT use, an increased diversity of MDT functions, a broader spectrum of discipline representation on MDTs, and an augmented use of training to implement and maintain MDTs. Results described here enable comparison with previous national surveys to shed light on the evolution of MDT system design and to suggest an agenda for future research.