Centring the patient in a Multi-Disciplinary Team approach: a qualitative case study of team work and supportive relationships with breast cancer patients

Research output: Contribution to conferencePosterpeer-review


Introduction, aims and objectives
• Multidisciplinary teams (MDTs) are increasingly at the forefront of cancer care provision in Australia with some evidence that they improve the experience and outcome of care delivery for patients.
• Further research is needed to explore how clinicians within MDTs support person-centred care for patients undergoing breast cancer treatment.1,2
• This study aimed to explore clinicians’ perspectives on MDTs, team work, and their relationships with patients with breast cancer.
• The objectives were to: a) describe clinicians’ views of their roles within the MDT; b) discuss clinicians’ outlook on their work relationships with other MDT members; and, c) assess clinicians’ interpretations of breast cancer patients’ relationships as they traversed treatment pathways.

• In-depth interviews were conducted with four members of an MDT; a clinical psychologist (CP), a radiation therapist (RT), a medical oncologist (MO), and a breast surgeon (SO); between August 2016 and November 2016.
• This study was based in a private, not-for-profit, teaching hospital, located in New South Wales, Australia.
• The revelatory case study approach was used as a single-case that allowed access to descriptive details of MDT professionals’ working habits.
• The case-study was considered holistically, using a single unit of analysis to build a rich picture of individual practice within the unique context within which MDTs function.

• Participants described their approach to practicing person-centred care as “effective communication” and “consistent information exchange”.
• MDT members suggested that these notions provided patients with reassurance, whilst enhancing understanding of patients’ values.
• Adapting to MDT styles and if necessary, changing communication strategies to support a more person-centric approach, was seen as valuable.
• Each individual clinician related to others in the professional team and to the patients being treated according to their own roles, responsibilities and disciplinary values (Figure 1).
• The medical oncologist and the surgeon tended to provide patients with clinical advice and guidance.
• Patients often drew on the support of allied healthcare professionals such as the clinical psychologist and radiation therapist to assist their decision-making, and cope with the intensity of cancer treatment.
• The clinical psychologist played a mediation role between the patient, the surgeon and the medical oncologist, to ensure patients’ values were reflected in treatment decisions.
• The radiation therapist would spend time personally contacting patients, to support their physical and psychological health during treatments.
• The aim of the MDT was to ensure patients remained at the centre of collaborative working practices, despite the fact that not all team members communicated directly with one another.

• Team-based and individual practices can vary by role, with each clinician operating according to work-based relationships that can influence patient care.
• Case study is an effective method for examining how practitioners interact with one another within a specific context, and how decisions are made, with the emphasis on the unique qualities of the case or ‘case conditions’.
• The results of the study will inform a larger, up-scaled study of MDT working practices in the context of breast cancer professional decision-making, and patients’ treatment experiences.
Original languageEnglish
Number of pages1
Publication statusPublished - 2018
Event35th International Conference in Healthcare Quality and Safety (ISQUA) - Kuala Lumpur, Malaysia
Duration: 23 Sep 201826 Sep 2018


Conference35th International Conference in Healthcare Quality and Safety (ISQUA)
CityKuala Lumpur


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