MD Anderson Cancer Center at Cooper, Camden, NJ
Sharif Ahmed , Greg Kubicek
Background: Multi-disciplinary tumor boards (MTB) are a way to generate quality patient care by allowing different specialties to provide insight into patient care. While the vast majority of hospital systems have MTB there are several aspects of how to run the most efficient MTB. The aim of this study was to determine if there was a difference in patients presented early versus late in MTB. Methods: At our institution we have disease specific weekly MTB. Patients are added to MTB based on order they are received (physicians or APN will send patient name to the disease specific nurse navigator). We recorded the time devoted to each patient and the number of providers that gave a comment or suggestion per patient. The time and number of comments were compared for patients presented at the start of MTB versus towards the end of MTB. Unpaired T test was used to compare time and comments. Results: We analyzed a total of 25 MTBs which corresponded to 241 patients. The median number of patients discussed per MTB was 9 (range 5 to 16). The median time spent per patient was 5.21 minutes and the median number of providers providing comments was 3 (range 1 to 9) with an average of 3.2. When analyzed by the first 8 patients versus the remainder, the median time spent was 6.1 minutes on the first 1-8 patients and 3.4 for > 8 (P < 0.0001). The mean number of comments was 3.4 for the first 1-8 patients and 2.4 for > 8 (P < 0.0001). Conclusions: We found that patients discussed towards the end of weekly MTB had less amount of time per devoted per patient and less discussion (as measured by number of providers supplying comments and suggestions). While the impact on long-term patient care is unclear we feel that this data is important in helping to ensure productive MTB discussions and avoid any arbitrary factor for reduced multidisciplinary insight. MTB should be cognitive of this time and attention biases.
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