Aims: To quantify the percentage of oncology patient referrals to regional sites which did not have a multidisciplinary team (MDT) meeting documented. Potential barriers to these patients not having a MDT meeting were then identified to guide strategies to improve patient care in the regional setting.
Methods: Retrospective data collection was completed from 1st July 2019 to 31st December 2019 for patients with referrals to the Western Australian Country Health Service (WACHS) Oncology service in Kalgoorlie and Esperance. Medical records and specific cancer databases were used to collect data on patient demographics, referral source, referral site, tumour type and MDT outcome.
Results: 81 patients met the inclusion criteria and were included in the data analysis. Overall, 14.8% (n=12) regional oncology patients did not have a MDT discussion identified. There was a difference in MDT meeting outcomes between referrals from the public versus private sectors (p<0.05), with 75% of patients with private referrals having no MDT meeting identified. No difference was found for MDT meeting outcomes for site of referral or specific tumour types. Limited data access across the public-private sectors, different metropolitan health services and regional sites was a major limitation for identifying completion of MDT meetings.
Conclusions: Current rates of MDT meeting completion and documentation for regional oncology patients falls below the desired standard set in the WACHS Cancer Strategy 2017-2022. Informal communication between clinicians is a potential barrier to formal MDT meeting completion, particularly in the private sector. Additionally, restricted access to consolidated MDT documentation is a barrier to monitoring of completion. This study recommends introduction of specialised oncology MDT coordinators to oversee completion of MDT meetings for all patients, and a centralised oncology MDT database allowing universal data access across health providers to optimise cancer care delivery in regional Western Australia.