Resultsof upper gi mdt questionnaire
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RESULTSOF UPPER GI MDT QUESTIONNAIRE. Sukhbir Ubhi National Clinical Lead for Upper GI Cancer Services Collaborative 'Improvement Partnership'. Aims. Obtain a “snapshot” view of the structure and function of Upper GI MDTs Identify organisational issues with MDTs

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RESULTSOF UPPER GI MDT QUESTIONNAIRE

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Resultsof upper gi mdt questionnaire

RESULTSOF UPPER GIMDT QUESTIONNAIRE

Sukhbir Ubhi

National Clinical Lead for Upper GI

Cancer Services Collaborative 'Improvement Partnership'


Resultsof upper gi mdt questionnaire

Aims

  • Obtain a “snapshot” view of the structure and function of Upper GI MDTs

  • Identify organisational issues with MDTs

  • Assess the use of “mapping” to identify problem areas

  • Identify bottlenecks


Responses

Responses

  • 57 Replies received

  • 51 Upper GI MDTs are fully up and running

  • 6 Upper GI MDTs are partially up and running


Frequency of upper gi mdt meetings

Frequency Of Upper GIMDT Meetings


Frequency that consultant surgeons attend mdts

Frequency That Consultant Surgeons Attend MDTs


Frequency that medical oncologists attend mdts

Frequency That Medical OncologistsAttend MDTs


Frequency that clinical oncologists attend mdts

Frequency That Clinical Oncologists Attend MDTs


Frequency that mdt clerks attend mdts

Frequency That MDT Clerks Attend MDTs


Frequency that specialist nurses attend mdts

Frequency That Specialist NursesAttend MDTs


Frequency that histopathologists attend mdts

Frequency That HistopathologistsAttend MDTs


Frequency that radiologists attend mdts

Frequency That RadiologistsAttend MDTs


Frequency that gastroenterologists attend mdts

Frequency That GastroenterologistsAttend MDTs


Frequency that palliative care representatives attend mdts

Frequency That Palliative CareRepresentatives Attend MDTs


Attendance at mdts

Attendance at MDTs


Major organisational problems with mdts

Major Organisational Problems With MDTS?

32 replied that they had major organisational

problems including:

  • No MDT co-ordinators

  • No timetabled activity

  • Limited or No dedicated accommodation or equipment

  • Audit/data collection

  • Obtaining notes/X-ray


Mapping exercise for upper gi patient journey

Mapping Exercise For Upper GI Patient Journey

  • 27out of 57 have already processed mapped with a 50% success rate

  • 5 are currently being planned

  • Difficulties encountered:

    -Complex pathway

    -Poor documentation/feedback of findings

    -Lack of action following process mapping

    -Hidden issues not "teased" out

    -No CSC person in post

    -No allocated time


Bottlenecks

"Bottlenecks"

  • Primary Care

    • Referral pathway

    • Patients not going to GP with symptoms

    • Poor support for patients

    • GP not recognising alarm symptoms


Bottlenecks1

"Bottlenecks"

  • Radiology/Endoscopy

    • Booking

    • Capacity

    • CT Waiting Times

    • CT Staging

    • Access to PET scanning


Bottlenecks2

"Bottlenecks"

  • Delays to first diagnostic test due to referrals to Gastroenterology, A&E or Care of the Elderly

  • Chemotherapy/Radiotherapy start dates

  • Histology reporting

  • Access to palliative care

  • Insufficient time for surgery

  • Bed availability HDU/POCCU/ITU

  • No Upper GI nurse specialist


Summary

Summary

  • Major Organisational issues with most MDTs

  • Variable attendance of “key” personnel at MDTs

  • Bottlenecks at every stage of the patient journey


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