Multidisciplinary Care: Optimising Team Performance

  • Frances M. Boyle
Part of the Cancer Treatment and Research book series (CTAR, volume 151)

The 2006 ASCO-ESMO consensus statement on Quality Cancer Care states that “optimal treatment of cancer should be provided by a team that includes, where appropriate, multidisciplinary medical expertise composed of medical oncologists, surgical oncologists, radiation oncologists, and palliative care experts, as well as oncology nurses and social workers. Patients should also have access to counselling for their psychosocial, nutritional and other needs” [1]. The statement highlights the need for patients to receive adequate information to allow participation as desired in decision making, to have their privacy protected and to be treated with dignity at all times. Access to clinical trials is identified as a hallmark of quality care, adding yet another layer of complexity to patients’ experience of a cancer diagnosis.


Team Member Tacit Knowledge Team Leader Diagnostic Specialist Team Climate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The work of the Pam McLean Centre in multidisciplinary communication has been a team effort, with creative input from Stewart Dunn, Paul Heinrich and Emma Robinson, and Robert Marshall of K-teams International P/L. Breast Cancer MDTs throughout Australia and New Zealand have shared their experience with us and the NHMRC National Breast Cancer Centre has enthusiastically implemented training initiatives. We are also grateful for the support of the Australian and New Zealand Rugby Unions, from whom we have learnt that great teams don’t just happen.


  1. 1.
    Horning SJ, Mellstedt H. ASCO-ESMO Consensus statement on Quality Cancer Care. JCO. 2006;24:3497–98.CrossRefGoogle Scholar
  2. 2.
    Chang JH, Vines E, Bertsch H, et al.The impact of a multidisciplinary breast cancer centre on recommendations for patient management. Cancer. 2001;91:1231–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Sainsbury R, Hayward B, Johnston C, et al. Influence of clinician workload and patterns of treatment on survival from breast cancer. Lancet. 1995;345:1265–70.PubMedCrossRefGoogle Scholar
  4. 4.
    Gillis CR, Hole DJ. Survival outcome of care by specialist surgeons in breast cancer. BMJ. 1996;312:145–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Gabel M, Hilton NE, Nathanson SD. Multidisciplinary breast cancer clinics. Do they work? Cancer. 1997;79:2380–4.PubMedCrossRefGoogle Scholar
  6. 6.
    Zorbas H, Barraclough B, Rainbird K, et al. Multidisciplinary care for women with early breast cancer in the Australian Context: What does it mean? Med J Aust. 2003;179:528–31.PubMedGoogle Scholar
  7. 7.
    Loh WP, Butow PN, Brown RF, Boyle F. Ethical communication in clinical trials: Issues faced by data managers in obtaining informed consent. Cancer. 2002, 95:2414–21.PubMedCrossRefGoogle Scholar
  8. 8.
    Boyle FM, Robinson E, Heinrich P, Dunn SM. “Cancer: Communicating in the team game” ANZ J Surg. 2004,74:477–81.PubMedCrossRefGoogle Scholar
  9. 9.
    Marshall RJ, Begeman M. Necessary but not sufficient: The role of expertise in technical team success. Cutter IT J. 2005;18:1–6.Google Scholar
  10. 10.
    National Breast Cancer Centre (Australia). Clinical Practice Guidelines for the Management of Early Breast Cancer. 2nd ed. Canberra: NHMRC; 2001.Google Scholar
  11. 11.
    National Breast Cancer Centre (Australia). Clinical Practice Guidelines: Providing Information, Support and Counseling for Women with Breast Cancer. Canberra. NHMRC; 2000.Google Scholar
  12. 12.
    Goldhirsch A, Glick JH, Gelber RD, et al. Meeting highlights: International expert consensus on the primary therapy of early breast cancer. Ann Oncol. 2005;16:1569–83.PubMedCrossRefGoogle Scholar
  13. 13.
    Herbert-Croteau N, Brisson J, Latreille J, Rivard M, Abdelaziz N, Marting G. Compliance with consensus recommendations for systemic therapy is associated with improved survival of women with node-negative breast cancer. JCO. 2004;22:3685–93.CrossRefGoogle Scholar
  14. 14.
    Fleissig A, Jenkins V, Catt S, Fallowfield L. Multidisciplinary teams in cancer care: are they effective in the UK. Lancet Oncol. 2006;7:935–43.PubMedCrossRefGoogle Scholar
  15. 15.
    National Breast Cancer Centre (Australia). Multidisciplinary meetings for cancer care: A guide for health services providers. National Breast Cancer Centre, Camperdown 2005 (
  16. 16.
    Magee LR, Laroche CM, Gilligan D. Clinical trials in lung cancer: Evidence that a programmed investigation unit and a multidisciplinary clinic may improve recruitment. Clin Oncol. 2001;13:310–11.Google Scholar
  17. 17.
    Boyle FM, Robinson E, Heinrich P, Dunn SM. Barriers to communication in multidisciplinary breast cancer teams. Proc ASCO. 2004.Google Scholar
  18. 18.
    Sidhom MA, Poulsen MG. Multidisciplinary care in oncology: Medicolegal implications of group decisions. Lancet Oncol. 2006;7:951–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Tuckman BW, Jensen MA. Developmental sequence in small groups. Psychol Bulletin 1965;63:384–99.CrossRefGoogle Scholar
  20. 20.
    Haward R, Amir Z, Borrill C, et al. Breast cancer teams: The impact of constitution, new cancer workload and methods of operation on their effectiveness. BJC. 2003;89,15–22.PubMedCrossRefGoogle Scholar
  21. 21.
    Honey P, Mumford A. Using Your Learning Style. Maidenhead, UK: Peter Honey Publications; 1986.Google Scholar
  22. 22.
    Back AL, Arnold RM. Dealing with conflict in caring for the seriously ill. JAMA. 2005;293:1374–81.PubMedCrossRefGoogle Scholar
  23. 23.
    Lyckholm L. Dealing with stress, burnout and grief in the practice of oncology. Lancet Oncol. 2001;2:750–5.PubMedCrossRefGoogle Scholar
  24. 24.
    Hall P, Weaver L. Interdisciplinary education and teamwork: A long and winding road. Med Educ. 2001;35:867–75.PubMedCrossRefGoogle Scholar
  25. 25.
    Brown RF, Butow PN, Henman MJ, Dunn SM, Boyle FM, Tattersall MNH. "Responding to the active and passive patient: flexibility is the key.” Health Expectations. 2002,5:330–40CrossRefGoogle Scholar
  26. 26.
    Fallowfield L, Jenkins V, Farewefll V, Saul J, Duffy A, Eves R. Efficacy of a Cancer Research UK communication skills training model for oncologists: A randomized controlled trial. Lancet. 2002;359:650–6.PubMedCrossRefGoogle Scholar
  27. 27.
    Maguire P, Pitceathly C. Key communication skills and how to acquire them. BMJ. 2002;325:697–700.PubMedCrossRefGoogle Scholar
  28. 28.
    Neil S, Scott C, Galetis S, Rodger A. The celluloid version of the multidisciplinary meeting:perceptions of consumers. ANZJ Surg. 2003;73:A7.CrossRefGoogle Scholar
  29. 29.
    Eales J, Batchelor L. Rugby Facts for Kids. Sydney: ABC Books; 2003.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Pam McLean Centre, University of SydneySydneyAustralia

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