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Arden L Corter,1 Brittany Speller,1 Kristin McBain,2 Frances C Wright,3,4 May Lynn Quan,5 Erin Kennedy,6 Selina Schmocker,6 Nancy N Baxter1,4,7On behalf of the RUBY Cohort Investigators1Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada; 2Applied Health Research Centre, St Michael’s Hospital, Toronto, Canada; 3Department of Surgery, Sunnybrook Hospital, Toronto, ON M4N 3M5, Canada; 4Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada; 5Department of Surgery, University of Calgary, Foothills Medical Centre, Calgary, AB T2N 2T9, Canada; 6Division of General Surgery, Mount Sinai Hospital, Toronto, Canada; 7Dalla Lana School of Public Health, University of Toronto, Toronto, CanadaCorrespondence: Nancy N BaxterDepartment of Surgery, St. Michael’s Hospital, 16-040 Cardinal Carter Wing, 30 Bond Street, Toronto, Ontario M5B1W8, CanadaTel +1416 864-5168Fax +1416 360-0637Email nancy.baxter@unityhealth.toBackground: Presentation to multidisciplinary cancer conferences (MCCs) supports optimal treatment of young women with breast cancer (YWBC). However, research shows barriers to MCC practice, and variation in professional attendance and referral patterns. A checklist may help overcome these barriers and support MCC practice with YWBC.Methods: We developed, piloted and evaluated an MCC checklist in sites participating in a pan-Canadian study (RUBY; Reducing the bUrden of Breast cancer in Young women). A survey assessed checklist processes and impacts, and checklist data were analysed for checklist uptake, MCC presentation rates and MCC processes including staff attendance.Results: Fifteen RUBY sites used the checklist (∼50%), mostly for data collection/tracking. Some positive effects on clinical practice such as increased presentation of YWBC at MCC were reported, but most survey participants indicated that MCC processes were sufficient without the checklist. Conversely, checklist data show that only 31% of patients were presented at MCC. Of those, 41% were recommended treatment change.Conclusion: Despite limited checklist uptake, there was evidence of its clinical practice benefit. Furthermore, it supported data collection/quality monitoring. Critically, checklist data showed gaps in MCC practice and low MCC presentation rates for YWBC. This contrasts with overall provider perceptions that MCCs are working well. Findings suggest that supports for MCC are needed but may best take the form of clear national practice recommendations and audit and feedback cycles to inform awareness of good MCC practice and outcomes. In this setting, tools like the MCC checklist may become helpful in supporting MCC practice.Keywords: breast neoplasm, multidisciplinary, cancer conference, implementation, evaluation, checklist |
