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Breast cancer teams:the impact of constitution, new cancer workload and methods of operation on their effectiveness

机译:乳腺癌小组:体质,新癌症工作量和手术方法对其有效性的影响

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摘要

National guidance and clinical guidelines recommended multidisciplinary teams (MDTs) for cancer services in order to bring specialists in relevant disciplines together, ensure clinical decisions are fully informed, and to coordinate care effectively. However, the effectiveness of cancer teams was not previously evaluated systematically. A random sample of 72 breast cancer teams in England was studied (548 members in six core disciplines), stratified by region and caseload. Information about team constitution, processes, effectiveness, clinical performance, and members' mental well-being was gathered using appropriate instruments. Two input variables, team workload (P=0.009) and the proportion of breast care nurses (P=0.003), positively predicted overall clinical performance in multivariate analysis using a two-stage regression model. There were significant correlations between individual team inputs, team composition variables, and clinical performance. Some disciplines consistently perceived their team's effectiveness differently from the mean. Teams with shared leadership of their clinical decision-making were most effective. The mental well-being of team members appeared significantly better than in previous studies of cancer clinicians, the NHS, and the general population. This study established that team composition, working methods, and workloads are related to measures of effectiveness, including the quality of clinical care. © 2003 Cancer Research UK.
机译:国家指南和临床指南建议为癌症服务设立多学科团队(MDT),以便将相关学科的专家召集在一起,确保充分了解临床决策并有效地协调护理。但是,以前尚未系统评估癌症小组的有效性。研究人员对英格兰的72个乳腺癌小组进行了随机抽样调查(六个核心学科的548名成员),按地区和病例数分层。使用适当的工具收集有关团队组成,过程,有效性,临床表现和成员心理健康的信息。两个输入变量,团队工作量(P = 0.009)和乳房护理护士的比例(P = 0.003),使用两阶段回归模型在多变量分析中积极预测整体临床表现。各个团队的投入,团队组成变量和临床表现之间存在显着的相关性。一些学科始终如一地认为自己团队的效能与平均值不同。共同领导其临床决策的团队最为有效。与先前对癌症临床医生,NHS和一般人群的研究相比,研究小组成员的心理健康状况明显好于其他人。这项研究表明,团队组成,工作方法和工作量与有效性的度量标准有关,包括临床护理的质量。 ©2003英国癌症研究。

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