Performance Evaluation of the Multi-disciplinary Team Members Committee for Cancer Management at Al-Shifa Medical Complex - Gaza

Mohammed Mahmoud Jaber
محمد محمود جبر
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Al-Quds University
Background and Aim. It is becoming a standard practice worldwide for cancer cases to be discussed by multidisciplinary team cancer committee members (MDTs or MDCM ) in order to formulate an expert-derived management plan with international patients safety lines on the level of medical responsibility and accountability by better efficient and effective cancer care. The MDTs cancer committee just was newly established in Al-Shifa Medical Complex five years ago. That was the first experience and only one at all MOH hospitals in Palestine. The study explores the performance evaluation of the MDT Cancer Members Committee for Cancer Management Al-Shifa Medical Complex in the Gaza Strip, to improve outcomes of cancer patient care and to provide supportive elements, mechanisms of process that enhanced formal environment and sharing the best practices. Design and methods. The methodology of study employed a descriptive, analytical and cross sectional design. I developed interview and questionnaire that used for data collection. A systematic sample was selected from three hospitals at Al-Shifa Medical Complex. Of the 116 specialists were selected from all doctors specialties from 47 departments, 115 responded and completed the questionnaires, with a response rate of 99.1% . The most majority of managerial positions were head of departments (41.7%). The overall reliability was 0.982 Cronbach' Alpha. Key measures for performance evaluation MDTs cancer performance indicators, included: attendance rate, cancer waiting time management CWTM, dynamics of case presentation process, preparation process, structure leadership, administration, organization, communication, coordination, case management and clinical decision making, barriers and challenges that effected MDTs cancer committee work. Result findings revealed that the overall status of performance of MDTs cancer committee members work for cancer management was good, with an average score of 67% reflecting perceptions of specialists towards the current status of performance of MDTs cancer committee. The results preparation of MDT cancer committee in (Pre-meeting stage) was the poorest domain and lowest result (60.2%), in (during-meeting stage) result was 67.6%, in post-meeting stage was 69.4%, the structure found 61.6%, organization, administration and leadership was 69.4%, communication and coordination was 68.8%, MDTs cancer case management and clinical decision making was the first domain and highest percentage 71.8%. On the other hand, availability and shortage of diagnostic and treatment resources became more limited, there was a greater urgency for technological solutions to be identified that would enable the MDTs cancer services to be delivered more effectively. There is limited training and research opportunities in cancer care for specialists as 75% had not received training courses related to cancer care at the last 5 years. M & E of performance indicators regularly had been lacking 90%of participants stated there were poor except attendance rate that was 2.3 times per month. In otherwise, the dynamics of cases presentation process shown as; the average case presentation by the member himself in your department was 3 cases, the average case presentation in MDTs cancer committee monthly was 10.73, the average leakage of cases without presentation in monthly was 7.55, the average delayed case presentation after the end of diagnosis monthly was around 4 cases, the total average delay of intervention more than two weeks after presentation monthly was 3 cases, the average expected time implementation of decisions after case discussion was very well around 9 days, the total average of time preparation case was 26 minutes, the average of time for weekly MDTs cancer meeting was 2.30 hours and the average of each case discussion during meeting was 15.5 minutes. Conclusion. This study developed and validated an evidence-based to support the quality of MDTs cancer committee members work. They felt positively about the evaluation that may help work effectively, improve inclusively, patient care and outcomes. There were major obstacles and barriers that threatened the sustainability and effectiveness of this model, improving the availability of resources and that could give them an opportunity to develop the required additional skills and contribute to improved MDTs cancer performance and ultimately cancer care.