Cancer Australia Lung Cancer Demonstration Project: Implementation and evaluation of a lung cancer

multidisciplinary team communication tool for GPs

Gemma Collett, Nicole Rankin, Clare Brown, Shiraz Abdulla, Merran Findlay, Philip Beale, Brian McCaughan, Tim Shaw, David Barnes

Royal Prince Alfred Hospital Concord Repatriation General Hospital

Background:• RPAH lung MDT commenced in 1984• Concord introduced a formalised MDT process in 2013• Discussion captured as free text• No routine correspondence to GPs• Gap identified

Cases presented

(RPAH/LH & Concord)

Formalised communication

tool

MDT discussion recorded

Lung MDT report sent

to GPs

MDT Puzzle???

Aims:• Develop, implement and evaluate a new lung MDT reporting

form to GPs• Improve communication flow to GPs following MDT• Evaluate timeliness, acceptability and appropriateness

Method:• Reporting process was mapped at RPAH & Concord• New form developed in consultation with GPs & MDT clinicians• Form generated within Powerchart Cerner, SLHD approval

Lung MDT Form

Patient: MRN: Age: Sex: DOB: Associated Diagnoses:

VISIT SUMMARYRoyal Prince Alfred HospitalMissenden RoadCAMPERDOWN NSW 2050

Pt Address: Pt Phone:General Practitioner: Address:GP Phone: GP Fax:

Location: Admission/Attendance: Date:

Presenting Medical Officer: Participants involved in discussion:

Relevant Medical History:

ECOG Performance Status (score):

Tumour stage: (table will be provided to GPs with report)

Diagnostic TestsChest X-Ray:CT:PET:Histopathology:

Discussion:Consensus/Treatment Plan:GP Follow-up:

Lung MDT Form

https://cancerstaging.org/references-tools/quickreferences/Documents/LungMedium.pdf 

LUNG CANCER STAGINGStage IA T1a, T1b N0 M0Stage IB T2a N0 M0Stage IIA T1a, T1b N1 M0  T2a N1 M0  T2b N0 M0Stage IIB T2b N1 M0  T3 N0 M0Stage IIIA T1, T2 N2 M0  T3 N1, N2 M0  T4 N0, N1 M0Stage IIIB T4 N2 M0  Any T N3 M0Stage IV Any T Any N M1a, M1b

LUNG MDT FORM

Reporting the Lung MDT in SLHD

Registrar completes lung MDT form on

PowerChart for all cases presented

Report sent to GPs (1-2 days) after MDT

Evaluation: GP brief phone survey

Cases presented atLung MDT

(RPAH/LH & Concord)

All reports are finalised and signed off

Results:• 20 GP surveys completed (12 rural & 8 metro)

“Emancipating for isolated GPs to receive this level of correspondence from big city hospitals”

“Rarely GPs get involved in such meetings”

“Good to know what treatment patient is having”

“There is a huge gap, good to get a summary of the discussion”

Appropriateness Timeliness Easy to interpret Treatment planning0

10

20

30

40

50

60

70

80

90

100

95 90 8595

GP Phone Survey summary (N=20) %

Cases presented

(RPAH/LH & Concord)

Formalised communication

tool

MDT discussion recorded

Lung MDT report sent

to GPs

Puzzle solved!!!

Implications:• GPs found form to be delivered in a manner that was timely,

acceptable and appropriate• Anticipated to benefit GPs in communicating outcomes and

treatment recommendations to patients• Lung MDT reporting form will become a model for other MDTs

across SLHD to establish a standardised communication tool

THANK YOU!!!

Acknowledgements:Many thanks to• Cancer Australia• LCDP team• Sydney Catalyst• Sydney LHD• RPAH & Concord MDT clinicians• Medicare Local GPs• Consumer representatives