TY - JOUR
T1 - Cognitive catch-22: Observational assessment of decision-making, interactions and team dynamics across two equal temporal halves of multidisciplinary oncology team meetings
AU - Soukup , Tayana
AU - Lamb, Benjamin W
AU - Green, James Sa
AU - Sevdalis, Nick
PY - 2019/4/14
Y1 - 2019/4/14
N2 - Background
Multidisciplinary team meetings are designed to bring diverse range of healthcare professionals together to discuss patients with cancer and formulate expert informed treatment recommendations; their decision-making (DM) was found variable, however.
Objective
We set out to examine how the factors proposed by functional perspective of group DM i.e. the quality of DM, interactions, internal factors (factors emanating from within the group such as group size) and external circumstances (factors coming from the outside of the team, such as time-workload pressure) fare between two equal temporal halves of the multidisciplinary oncology meetings.
Design
This was a prospective cross-sectional observational study.
Setting and participants
Three cancer multidisciplinary teams were recruited with 44 members overall. Thirty weekly meetings were filmed over 3 months respectively.
Measures
Three validated observational instruments were used to measure quality of DM, interactions and discussion complexity for 822 individual patient discussions.
Results
There was a significant difference between 1st and 2nd half of meetings, F(11,809)=21.56, p<.001; Hotelling’s Trace=0.29. partial η2=.23, with a reduced quality of DM (p=.001) and interactions (p=.001), group size (p=.003), and clinical complexity (p=.001), and increased negative reactions (p=.001) and time-workload pressure (p=.001).
Conclusion
While patient-discussions are significantly simpler in the 2nd half of the meeting, there is significantly less time left to discuss the remaining patients as the teams are rapidly attempting to close the time-workload gap and reach a treatment recommendation for all patients put forward for the meeting. Arguably this further adds to the cognitive taxation in the teams with implications for quality and safety.
AB - Background
Multidisciplinary team meetings are designed to bring diverse range of healthcare professionals together to discuss patients with cancer and formulate expert informed treatment recommendations; their decision-making (DM) was found variable, however.
Objective
We set out to examine how the factors proposed by functional perspective of group DM i.e. the quality of DM, interactions, internal factors (factors emanating from within the group such as group size) and external circumstances (factors coming from the outside of the team, such as time-workload pressure) fare between two equal temporal halves of the multidisciplinary oncology meetings.
Design
This was a prospective cross-sectional observational study.
Setting and participants
Three cancer multidisciplinary teams were recruited with 44 members overall. Thirty weekly meetings were filmed over 3 months respectively.
Measures
Three validated observational instruments were used to measure quality of DM, interactions and discussion complexity for 822 individual patient discussions.
Results
There was a significant difference between 1st and 2nd half of meetings, F(11,809)=21.56, p<.001; Hotelling’s Trace=0.29. partial η2=.23, with a reduced quality of DM (p=.001) and interactions (p=.001), group size (p=.003), and clinical complexity (p=.001), and increased negative reactions (p=.001) and time-workload pressure (p=.001).
Conclusion
While patient-discussions are significantly simpler in the 2nd half of the meeting, there is significantly less time left to discuss the remaining patients as the teams are rapidly attempting to close the time-workload gap and reach a treatment recommendation for all patients put forward for the meeting. Arguably this further adds to the cognitive taxation in the teams with implications for quality and safety.
U2 - 10.31234/osf.io/pvgfn
DO - 10.31234/osf.io/pvgfn
M3 - Article
JO - PsyArXiv
JF - PsyArXiv
ER -