Uro-oncology multidisciplinary teams (MDTs) deliver comprehensive cancer care across Australia although a multitude of individuals do not receive a timely MDT discussion and little is known about the clinical decision-making among MDTs or how patients’ needs, and preferences are embedded. 

 

To understand the clinical decision-making process among the uro-oncology MDT and how patients are engaged in the process.

 

This study was conducted in a Metropolitan Cancer Regional Hospital in Australia. Semi-structured interviews were conducted with healthcare professionals of a uro-oncology MDT from June 2022 to July 2022. The cognitive continuum theoretical model of clinical decision-making along with Braun and Clark’s six-steps of thematic analysis were applied, and a narrative synthesis undertaken.

 

Three themes emerged, 1) the ‘role and scope of the uro-oncology MDT’, 2) ‘lack of person-centred clinical decision-making’ and 3) the ‘barriers and facilitators.’ Individuals do not attend, nor are they able to attend MDT discussions. The reasons for patient exclusion include logistics, time constraints, medical jargon and privacy reasons. Identified barriers included: incomplete referral documentation and a lack of attendance from all members of the MDT.

 

The MDT had a prominent biomedical focus which lacked person-centred considerations. Psycho-social issues (including urinary, bowel and sexual dysfunction) are scantly discussed, however, patients’ preferences for treatments are considered in the clinical decision-making process.

 

This study provides further evidence to indicate that uro-oncology MDTs continue to have a biomedical focus which impedes holistic care. Evidently the whole person is not being treated which likely results in reduced quality of life and compounds unmet care needs.

 

Blake Askelin1, Alicia Hind2,3, Catherine Paterson4,5,6
 
 

1.     Canberra Health Services, Garran, ACT, 2605

2.     School of Nursing, Midwifery and Public Health, University of Canberra, Bruce ACT 2617

3.     Faculty of Health, University of Canberra, Bruce, ACT 2617

4.     ACT Health, Phillip, ACT 2605

5.     PACES Research Group, University of Canberra, Bruce ACT 2617

6.     Icon Cancer Centre, Bruce ACT 2617