MULTIDISCIPLINARY TEAM (MDT) EXPERIENCE IN THE INCORPORATION OF PACS AND REAL-TIME ELECRONIC RECORD-KEEPING AT MEETINGS

B. Kane1, M. Morrough, H. Al Chalabi, S. O’Keeffe, B. Dunne, M. J. Kennedy, D. Hollywood, T. Boyle, E. Connolly, R. McDermott, K. O’Byrne, F. Lynam, S. Luz

1IRCSET Research Fellow

Overview• Background

• Development

• Response

• Conclusion

Method

• Survey

• Interviews

• Observation

• Work process Data

Background - Change

• PACS

• Electronic Patient Record implementation

• Designation as Referral Centre

• Guidelines – MDT Meetings

• Increased Number of Patients

• Public Awareness

Team Profile - 2011ROLE Number

Clinicians 9

Radiologist 1

Pathologist 3

Oncologist 6

Nurse 6

Physiotherapist 1

Data/Audit Manager 1

Administration staff 1

Total 28

Vocal Non-Vocal

13 (46%) 15 (54%)

Team Profile - Clinicians

ROLE Number

Consultant 8

Specialist Registrar 3

Registrar 5

Intern 2

Total 18

Team Profile - Experience

Experience(Years)

Frequency

< 1 2

1 - 3 8

4 - 10 12

11 - 20 3

> 20 2

Not given 1

Total 28

Team Profile – MDTs and MDTMs

MDTMs per week

Number

1 12

2 4

3 6

5 1

1 - 2 3

2 - 3 2

Total 28

MDTs to which member belongs

Number

1 19

3 6

10 3

Total 28

Data - Workload

In 2010:

28 patients discussed more than once.Three of these were discussed 3 times

*In 2005:

One MDTM cancelledNo. Individuals not noted

Month of November

22 working days2005* 2010

Increase%

Patient Cases - 206 255

Patient Case Discussions

58 (Mean 14)

237(Mean 48)

309(243)

How

has increase been

accomplished?

1 2 3

-100

-50

0

50

100

150

200

250

300

350

2010

20052003

Increase accommodatedMore TIME

Instead of 8.00am to 9.00am

Now meet 07.45am to almost 09.45am

Represents increase from

14 per hour in 2005

to

24 per hour 2010

= 71% increase in number of discussion

Coping Strategies

Grouping

Prioritising

Increased Formalisation

Incorporate Electronic Record Keeping

Electronic Record-Keeping

Electronic Record-Keeping

Other Consequences

Less Clinical summary

Reduced time spent on radiology images

Mammogram, US, MR

Pathology pictures rarely shown

Less discussion, less participation

Acknowlegements• Breast Team at St James’s Hospital

• IRCSET Research Fellowship

• St James’s Hospital Board