Aims
• This presentation is intended to provide a
brief introduction to MDT-FIT.
• In it we address the following questions;
– What is MDT-FIT?
– Why is MDT assessment important?
– Why do MDT-FIT?
• Plus, getting started using MDT-FIT…
What is MDT-FIT?
• MDT-FIT (Feedback for Improving Teamworking) is Trustrun/resourced tool designed to enable cancer MDTs to selfassess and receive feedback on how their team performs against
the standards set out in the ‘The Characteristics of an Effective
MDT’ (NCAT, 2010, http://www.ncin.org.uk/mdt.).
• It was developed with input from over 100 MDTs and designed
to be a Team owned process (developmental not judgemental).
• MDT-FIT is supported by a comprehensive web-based platform
and consists of a three stage process to be completed over an 812 week period, with an annual review.
• The three stages involve: assessment, feedback, discussion
MDT-FIT processes
1a: Team selfassessment: online
survey completed by
each MDT member
1b: Independent
assessment:
observational
assessment of at least
one MDT meeting
2: Feedback
report shared:
synthesis of MDT
members and
independent
observers’
assessments, sent
to all MDT
members and
their facilitator
3a: Preparatory
meeting: MDT lead and
facilitator may meet to
discuss feedback
3b: Facilitated team
discussion of feedback:
team agree actions in a
facilitated meeting
3c: Trust management
discussion: to address
issues requiring Trust
input
Actions implemented and reviewed
1a: Team self-assessment:
•Each member will be sent an email link to register
and complete the survey*
•Survey takes around 15mins to complete
1b: Independent assessment:
•Observers are independent Trust managers or
clinicians (i.e. outside the team/not be involved with
team members on day to day basis)
•Observers should have experience/good knowledge
of MDT working
•Provided with an assessment criteria
*For details about the development, reliability and validity of the survey see, Taylor C, Brown K, Lamb B, Harris J,
Sevdalis N, Green, JSA. Development and testing TEAM (Team Evaluation and Assessment Measure), a self-assessment
tool to improve cancer multidisciplinary teamwork. Annals of Surgical Oncology. 2012; 19: 4019-4027
2: Feedback report shared:
•Synthesis of MDT members/independent
observers’ assessments
•Emailed to MDT members/facilitator (at least 7
days before team facilitated discussion)
•No interpretation of the data- that’s up to the team
to decide what to discuss!
•Remember- the team owns the report.
•It’s the teams decision whether they share their
report more widely with Trust colleague
•Team members should all read the report before
the next stage…
3a: Preparatory meeting:
•Useful for MDT lead/facilitator to have short meeting (phone or
face to face) to discuss provide some context/details about the
MDT
3b: Facilitated team discussion of feedback:
• 1 hour meeting
• Senior Trust clinician or manager with facilitation skills, helps
the whole team to discuss feedback and agree an action plan
•Decide which actions need Trust management input to resolve
3c: Trust management discussion:
•Lead/ facilitator and others meet with Cancer Services Manager
and Cancer Clinical Lead to share action plan and help address
issues outside of the team’s remit (i.e. requiring Trust input to
resolve)
Actions implemented and reviewed
•Over the next year actions are implemented
•Action plans should be….
Specific: clear/unambiguous
Measurable: to assess progress
Achievable: it may stretch you, but still within capacity
Relevant: actions that matter
Time-specific: commit to a time frame
•Progress of implementation should be reviewed at
regular intervals
• Named MDT members are responsible for taking
individual actions forward
Why is assessment of MDT-working
important?
• Some aspects of MDT working are assessed - adherence to these
standards, within and between tumour types, is variable (NCAT, 2012).
• Other aspects of teamworking are not as easily translated to measurable
standards, but may impact on the quality of patient care (Lamb et al, 2011a;
Lamb et al, 2011b) : e.g. leadership, the patient-centredness of the decisionmaking process, inclusiveness and quality of communication between
team members.
• Variation in these factors has been related to poorer patient (and staff)
experience and poorer clinical outcomes (Blazeby et al 2006, Stalfors et all 2007,
Lanceley et al, 2008)
• A survey of cancer team members showed that they would like a tool to
enable them to self-assess their team-work and meetings; MDT-FIT seeks
to provide this tool (Taylor et al, 2009)
Why do MDT-FIT?
• MDT-FIT WORKS most MDT members who have taken part (74%)
expressed positive views about MDT-FIT and its capacity to facilitate
improvements to team-work
• On average teams agree 8 actions for improvement
• MINIMAL TIME AND NHS RESOURCE The average team member
completes the self-assessment, reads the feedback report and participates
in the facilitated team discussion (about 90-120 mins in total).
• MDT-FIT makes use of existing Trust expertise to support the process
• QUALITY ASSURANCE For MDTs (and at an organisational level), MDT-FIT
provides a useful mechanism for Trusts to support their MDTs to assess
their clinical governance and quality standards.
Getting started using MDT-FIT
• All members agree a date for the facilitated team
discussion (at least 6 weeks in advance)
• Suitable facilitator/observer identified by Trust
Champion
• Email addresses provided by team to Trust champion
• Facilitator/MDT lead invited to register online/agree
team details
• Team members invited to register and complete survey
• Observer invited to register and complete their
assessment
For more details see
www.greencrossmedical.com
or
http://www.youtube.com/watch?v
=8bWI2ieSjWE
•Last updated Dec 2013