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A Daily Diagnostic Multidisciplinary Meeting to Reduce Time to Definitive Diagnosis in the Context of Primary Bone and Soft Tissue Sarcoma

Authors Hartley LJ, Evans S, Davies MA, Kelly S, Gregory JJ

Received 22 June 2020

Accepted for publication 12 August 2020

Published 15 January 2021 Volume 2021:14 Pages 115—123

DOI https://doi.org/10.2147/JMDH.S266014

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Laura J Hartley,1 Scott Evans,2 Mark A Davies,2 Suzanne Kelly,2 Jonathan J Gregory2

1University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 2The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK

Correspondence: Laura J Hartley
University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Tel +44 121 424 0000
Email l.hartley2@nhs.net

Background and Objectives: Cancer services are under increasing pressure to deliver waiting time targets. Our service has seen referral numbers increase to over 3000 per annum, with more than 80% coming from secondary care. In order to deliver a responsive service, the department has introduced a daily diagnostic multidisciplinary meeting (DMDT) with the aim being stratification of resources by directing rapid access to clinics and diagnostics to those felt to be at greatest risk of malignancy at the start of the pathway. It also aimed to improve communication with patients and referrers, consistency in decision making and deliver improved diagnostic turn-around times in a sustainable manner. An evaluation was undertaken to assess whether the introduction of the DMDT has improved the pathway, the primary endpoint being a reduction in time to definitive diagnosis (TTDD). Secondary endpoints included measurements of efficiency and whether there has been a reduction in variation in practice.
Methods: Retrospective access to a prospective database over a 1-month period before (2015) and after (2018) the intervention.
Results: The introduction of the DMDT has led to a reduction in TTDD (7 days). The service also has an added benefit in reducing average total patient miles travelled over the course of diagnosis by 22.68 miles.
Conclusion: The introduction of a diagnostic MDT at the start of the pathway does lead to an improvement in service efficiency and a reduction in TTDD.

Keywords: multidisciplinary, cancer, oncology, diagnosis, waiting times, sarcoma

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