Mapping Current Organizational Structure and Improvement Points of Breast Cancer Multidisciplinary Team Meetings – An Interview Study

Figures & data

Table 1 An Overview of All Study Participant per Hospital. The Specialty of Nurse Specialists is Depicted Between Brackets

	General Hospital	Academic Hospital	Cancer Institute
Participant specialism	1 Surgery resident 1 Surgeon 1 Pathologist 1 Radiologist 1 Radiotherapist 1 Nurse specialist (oncology)	2 Surgeons 1 Nurse specialist (surgery) 1 Oncologist 1 Nurse specialist (oncology) 1 Pathologist 1 Nurse specialist (plastic surgery) 1 Radiotherapist 1 Radiologist	1 Surgeon 1 Surgery resident 1 Surgery fellow 1 Oncologist 1 Pathologist 1 Radiologist 1 Radiotherapist 1 Nurse specialist (oncology) 1 Research nurse (Policy officer for breast MDTM)

Table 2 Overview of MDTM Organizational Structure per Included Hospital

	General Hospital	Academic Hospital	Cancer Institute
Frequency and focus of MDTM (average/max. patients discussed per MDTM)	Weekly general breast cancer MDTM (average of 30–40 patients)	Weekly general breast cancer MDTM (average of 15–25 patients)	- Weekly MDTM for complex cases (max. 18 patients) - MDTM for second opinions and new patients twice a week (max. 10 patients) - MDTM for pathology results twice a week - MDTM for hormonal treatment evaluation once every two weeks
Chair	Surgeon	Radiotherapist	Surgeon, oncologist or nurse specialist

Figure 1 Summary of participant comments regarding the preparation of breast cancer MDTMs. (A) Duration of preparation: estimated average time spent preparing the MDTM per participant. (B) Preparation methods: the method of preparation used per participant. (C) Preparation remarks: comments regarding the preparation of colleagues. (D) Benefits of preparation: factors related to preparation that were considered beneficial for MDTMs.

Table 3 List of Points of Improvement for Breast Cancer MDTMs as Stated by the Participants

	Points of Improvement
Preparation	Improve preparation of all attendees. Provide a clearly formulated MDTM question when registering a patient for the MDTM.
Structure	Improve structure of patient information in registration form. Make sure case presentations and discussions are to the point. Presentation by treating physician or by another specialist who knows the patient.
Information availability	Improve the availability of patient information and summary prior to the MDTM. Improve the availability of patient information and summary during the MDTM, discuss only complete cases. Streamline the process of looking up information in the electronic medical records.
Meeting discipline	Ensure strict leadership by the person who is chairing the MDTM. Avoid technical and/or software issues, improve loading of images, and ensure trust in the used systems. Better focus and motivation of all attendees.

Figure 2 Summary of participant comments regarding the facilitators and barriers of time management during breast cancer MDTMs. (A) Structure: facilitators and barriers concerning the structure of breast cancer MDTMs. (B) Availability of information: facilitators and barriers concerning patient information. (C) Meeting discipline: facilitators and barriers concerning the way MDTMs are moderated.