Table 1

MDT-OARS quality criteria and shortened manual for rating each of 15 observable characteristics of effective teamworking in MDT meetings
Characteristic of effective MDT working Quality Criteria Quality of team working (score in brackets)
Very Poor Poor Good Very Good
The Team
Attendance Presence of relevant core team members at the meeting at least one core team member (and their deputy) is not present for the whole meeting at least one core team member (and deputy) is absent for most of the meeting (≥3 cases) at least one core team member (and deputy) is absent for part of the meeting (≤ 2 cases) all core team members (or deputy) present for whole meeting
(1) (2) (3) (4)
Leadership: chairing of meeting · Keeps meeting to agenda (i.e. moves onto next case) Satisfies none of criteria Only satisfies 1–2 of criteria Satisfies 3 of criteria Evidence of all of the criteria
· Encourages overall participation
· Encourages focussed discussion
· Articulates recommendation (1) (2) (3) (4)
Teamworking & culture
a) Inclusion of relevant team members · All relevant core members are actively and appropriately involved Satisfies 1/none of criteria Satisfies 2–4 of criteria Satisfies “all relevant core members are actively and appropriately involved” and at least 3 other criteria Satisfies all of the criteria
· Meeting not dominated by 1-2 people
· Input/questions volunteered and encouraged
· Contributions facilitate decision-making and/or inform discussion
· Consensus of decision-making (1) (2) (3) (4)
b) Team Sociability · Evidence of humour Satisfies none of the criteria Satisfies 1 of criteria Satisfies 2–3 of criteria Satisfies all of criteria
· Team appear relaxed with each other
· Warm and supportive team environment
· Friendly and cooperative communicative style (1) (2) (3) (4)
c) Mutual respect · Focussed attention Only satisfies 1 or none of Satisfies 2–3 of criteria Evidence of respect, Strong evidence of
· Respect for speaker criteria evidence of at least 4 respect in all/almost all
· No concurrent discussions criteria cases
· Asking and valuing relevant contributions
· General sense of politeness/courtesy (inc mobile phone etiquette) (1) (2) (3) (4)
d) tension and conflict Not rated on the same scale – see bottom of table
Personal development & training Observable communication of research evidence and/or instances of learning No observable communication of research evidence or instances of learning Minimal communication of research evidence or instances of learning Structured presentation of research evidence and/or learning through formal discussion (e.g. of audit findings
(1) (2) (3)
Infrastructure for meetings
Meeting venue · Room size appropriate for number of team members Satisfies only 1 or none of criteria Satisfies 2 of the criteria Satisfies 3 of the criteria Satisfies all of the criteria
· Layout of chairs enables accessible viewing of diagnostics
· Layout of room allows accessible viewing of other team members
· All members seated on a chair
· Suitable venue in terms of location, temperature, lighting etc (1) (2) (3) (4)
Technology & equipment Availability of diagnostic equipment to view and share images and pathology with the team. No radiology imaging facilities Light box available with hard copy film Current images available digitally with facilities for projecting/viewing images Current images available digitally with facilities for projecting/viewing images and capability of accessing retrospective images (e.g. use of PACS)
Availability of multiple screens scores extra 1 point. Score out of possible 9 is then standardised onto 1-4 scale to give overall rating.
(1) (2) (3) (4)
No histopathology facilities Microscope Microscope with facilities for projecting/viewing specimen/biopsy Microscope with facilities for projecting and viewing specimen/biopsy and accessing retrospective data
(1) (2) (3) (4)
Meeting organisation and logistics
Preparation prior to meetings:
a) agenda Availability and content of agenda No available agenda Agenda, but limited info Comprehensive agenda
(1) (2) (3)
b) prioritisation of complex cases Prioritisation of complex cases on agenda to enable sufficient time for their discussion No attempt is made to order cases in terms of complexity and an inappropriate amount of time is spent on cases (i.e. too much or too little) Some attempt is made to order cases in terms of complexity but an inappropriate amount of time is spent discussing some of the cases Patient cases are discussed in a clear order but time is used inappropriately in some cases Patient cases are discussed in a clear order and an appropriate amount of time is spent discussing each case
(1) (2) (3) (4)
Organisation/admin during meetings:
a) patient notes Availability of patient notes No patient records available at meeting Some required past/current reports not available Hardcopy and all necessary past/current reports available Electronic access to patient notes and all necessary past/current reports available
(1) (2) (3) (4)
b) case presentation Comprehensiveness and coherence of case presentation Rambling; entirely reading from notes; does not seem familiar with patient Some evidence of familiarity with patient and info presented in reasonable fashion Comprehensive succinct coherent presentation (evidence of familiarity with patient and findings)
(1) (2) (3)
Clinical decision making
Patient centred care Includes mention of patient-based information (e.g. demography; co-morbidities; psycho-social or supportive needs; patient wishes/family preferences) Patient-centred factors sufficiently acknowledged in less than 20% cases Patient-centred factors sufficiently acknowledged in less than 50% cases Patient-centred factors sufficiently acknowledged in 50% + cases (but not all cases) Patient-centred factors sufficiently acknowledged in all cases
(1) (2) (3) (4)
Treatment plans Clarity of treatment plan Treatment plan not discernable Treatment plan communicated verbally Treatment plan communicated verbally and recorded Treatment plan communicated verbally, recorded with a clearly articulated plan regarding the next steps.
(1) (2) (3) (4)
Characteristic of Effective MDT-working Quality Criteria Quality of team-working (score in brackets)
Teamworking & culture severe and sustained conflict overt conflict un-sustained tension sustained tension un-sustained no tension
(−4) (−3) (−2) (−1) (0)
d) tension/conflict Extent of tension and/or conflict observable in the team ≥1clear example of conflict observed which persists throughout meeting ≥1clear example of conflict observed does not persist throughout meeting ≥1 instance of tension observed which persists throughout meeting ≥1 instance of tension observed but does not persist throughout meeting No tension

Taylor et al.

Taylor et al. BMC Cancer 2012 12:202   doi:10.1186/1471-2407-12-202

Open Data