29 results found
Winters DA, Soukup T, Sevdalis N, et al., 2021, The cancer multidisciplinary team meeting: in need of change? History, challenges and future perspectives, BJU INTERNATIONAL, Vol: 128, Pages: 271-279, ISSN: 1464-4096
Soukup T, Murtagh GM, Lamb BW, et al., 2021, Gaps and overlaps in cancer multidisciplinary team communication: analysis of speech, Small Group Research, Vol: 52, Pages: 189-219, ISSN: 1046-4964
Guided by the principles of conversation analysis, we examined the communication practices used to negotiate levels of participation in cancer multidisciplinary team meetings and their implications for patient safety. Three cancer teams participated. Thirty-six weekly meetings were video recorded, encompassing 822 case reviews. A cross-section was transcribed using Jefferson notation. We found a low frequency of gaps between speakers (3%), high frequency of overlaps (24%), and no-gaps-no-overlaps (73%), suggesting fast turn transitions. Securing a turn to speak is challenging due to a systematic reduction in turn-taking opportunities. We contribute to group research with the development of a microlevel methodology for studying multidisciplinary teams.
Soukup T, Sevdalis N, Green JSA, et al., 2021, Making Tumor Boards More Patient-Centered: Let's Start With the Name., JCO Oncol Pract
Estevao C, Fancourt D, Dazzan P, et al., 2021, Scaling-up Health-Arts Programmes: the largest study in the world bringing arts-based mental health interventions into a national health service, BJPSYCH BULLETIN, Vol: 45, Pages: 32-39, ISSN: 2056-4694
Soukup T, Murtagh G, Lamb BW, et al., 2021, Degrees of Multidisciplinarity Underpinning Care Planning for Patients with Cancer in Weekly Multidisciplinary Team Meetings: Conversation Analysis, JOURNAL OF MULTIDISCIPLINARY HEALTHCARE, Vol: 14, Pages: 411-424, ISSN: 1178-2390
Soukup T, Sevdalis N, Green JSA, et al., 2020, Quality improvement for cancer multidisciplinary teams: lessons learned from the Anglian Germ Cell Cancer Collaborative Group, BRITISH JOURNAL OF CANCER, Vol: 124, Pages: 313-314, ISSN: 0007-0920
Soukup T, Lamb BW, Morbi A, et al., 2020, A multicentre cross-sectional observational study of cancer multidisciplinary teams: Analysis of team decision making, Cancer Medicine, Vol: 9, Pages: 7083-7099, ISSN: 2045-7634
BackgroundMultidisciplinary teams (MDT) formulate expert informed treatment recommendations for people with cancer. We set out to examine how the factors proposed by the functional perspective of group decision making (DM), that is, interaction process, internal factors (factors emanating from within the group such as group size), external circumstances (factors coming from the outside of the team), and case‐complexity affect the quality of MDT decision making.MethodsThis was a cross‐sectional observational study. Three cancer MDTs were recruited with 44 members overall and 30 of their weekly meetings filmed. Validated observational instruments were used to measure quality of DM, interactions, and complexity of 822 case discussions.ResultsThe full regression model with the variables proposed by the functional perspective was significant, R2 = 0.52, F(20, 801) = 43.47, P < .001, adjusted R2 = 0.51. Positive predictors of DM quality were asking questions (P = .001), providing answers (P = .001), team size (P = .007), gender balance (P = .003), and clinical complexity (P = .001), while negative socioemotional reactions (P = .007), gender imbalance (P = .003), logistical issues (P = .001), time‐workload pressures (P = .002), and time spent in the meeting (P = .001) were negative predictors. Second half of the meetings also saw significant decrease in the DM quality (P = .001), interactions (P = .001), group size (P = .003), and clinical complexity (P = .001), and an increase in negative socioemotional reactions (P = .001) and time‐workload pressures (P = .001).DiscussionTo the best of our knowledge, this is the first study to attempt to assess the factors proposed by the functional perspective in cancer MDTs. One novel finding is the effect of sociocognitive factors on team DM quality, while another is the cognitive‐catch 22 effect: while the case discussions are significantly simpler in the second half of the meeting, there is significantly less time left to discuss
Soukup T, Morbi A, Lamb BW, et al., 2020, A measure of case complexity for streamlining workflow in multidisciplinary tumor boards: Mixed methods development and early validation of the MeDiC tool, Cancer Medicine, Vol: 9, Pages: 5143-5154, ISSN: 2045-7634
Background and ObjectiveThere is increasing emphasis in cancer care globally for care to be reviewed and managed by multidisciplinary teams (ie, in tumor boards). Evidence and recommendations suggest that the complexity of each patient case needs to be considered as care is planned; however, no tool currently exists for cancer teams to do so. We report the development and early validation of such a tool.MethodsWe used a mixed‐methods approach involving psychometric evaluation and expert review to develop the Measure of case‐Discussion Complexity (MeDiC) between May 2014 and November 2016. The study ran in six phases and included ethnographic interviews, observations, surveys, feasibility and reliability testing, expert consensus, and multiple expert‐team reviews.ResultsPhase‐1 : case complexity factors identified through literature review and expert interviews; Phase‐2 : 51 factors subjected to iterative review and content validation by nine cancer teams across four England Trusts with nine further items identified; Phase 3 : 60 items subjected to expert review distilled to the most relevant; Phase 4 : item weighing and further content validation through a national UK survey; Phases 5 and 6 : excellent interassessor reliability between clinical and nonclinical observers, and adequate validity on 903 video case discussions achieved. A final set of 27 factors, measuring clinical and logistical complexities were integrated into MeDiC.ConclusionsMeDiC is an evidence‐based and expert‐driven tool that gauges the complexity of cancer cases. MeDiC may be used as a clinical quality assurance and screening tool for tumor board consideration through case selection and prioritization.
Pallari E, Soukup T, Kyriacou A, et al., 2020, Assessing the European impact of alcohol misuse and illicit drug dependence research: clinical practice guidelines and evidence-base policy, EVIDENCE-BASED MENTAL HEALTH, Vol: 23, Pages: 67-76, ISSN: 1362-0347
Soukup T, Lamb BW, Sevdalis N, et al., 2020, Streamlining cancer multidisciplinary team meetings: challenges and solutions, BRITISH JOURNAL OF HOSPITAL MEDICINE, Vol: 81, ISSN: 1750-8460
Soukup T, Lamb BW, Weigl M, et al., 2019, An Integrated Literature Review of Time-on-Task Effects With a Pragmatic Framework for Understanding and Improving Decision-Making in Multidisciplinary Oncology Team Meetings, FRONTIERS IN PSYCHOLOGY, Vol: 10, ISSN: 1664-1078
Soukup T, Gandamihardja TAK, McInerney S, et al., 2019, Do multidisciplinary cancer care teams suffer decision-making fatigue: an observational, longitudinal team improvement study, BMJ OPEN, Vol: 9, ISSN: 2044-6055
Jalil R, Soukup T, Akhter W, et al., 2018, Quality of leadership in multidisciplinary cancer tumor boards: development and evaluation of a leadership assessment instrument (ATLAS), WORLD JOURNAL OF UROLOGY, Vol: 36, Pages: 1031-1038, ISSN: 0724-4983
Soukup T, Lamb BW, Arora S, et al., 2018, Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature, Journal of Multidisciplinary Healthcare, Vol: 11, Pages: 49-61, ISSN: 1178-2390
In many health care systems globally, cancer care is driven by multidisciplinary cancer teams (MDTs). A large number of studies in the past few years and across different literature have been performed to better understand how these teams work and how they manage patient care. The aim of our literature review is to synthesize current scientific and clinical understanding on cancer MDTs and their organization; this, in turn, should provide an up-to-date summary of the current knowledge that those planning or leading cancer services can use as a guide for service implementation or improvement. We describe the characteristics of an effective MDT and factors that influence how these teams work. A range of factors pertaining to teamwork, availability of patient information, leadership, team and meeting management, and workload can affect how well MDTs are implemented within patient care. We also review how to assess and improve these teams. We present a range of instruments designed to be used with cancer MDTs – including observational tools, self-assessments, and checklists. We conclude with a practical outline of what appears to be the best practices to implement (Dos) and practices to avoid (Don’ts) when setting up MDT-driven cancer care.
Archer SA, Hull L, Soukup T, et al., 2017, Development of a Theoretical Framework of Factors Affecting Patient Safety Incident Reporting: A Theoretical Review of the Literature, BMJ Open, Vol: 7, ISSN: 2044-6055
Objectives The development and implementation of incident reporting systems within healthcare continues to be a fundamental strategy to reduce preventable patient harm and improve the quality and safety of healthcare. We sought to identify factors contributing to patient safety incident reporting.Design To facilitate improvements in incident reporting, a theoretical framework, encompassing factors that act as barriers and enablers ofreporting, was developed. Embase, Ovid MEDLINE(R) and PsycINFO were searched to identify relevant articles published between January 1980 and May 2014. A comprehensive search strategy including MeSH terms and keywords was developed to identify relevant articles. Data were extracted by three independent researchers; to ensure the accuracy of data extraction, all studies eligible for inclusion were rescreened by two reviewers.Results The literature search identified 3049 potentially eligible articles; of these, 110 articles, including >29 726 participants, met the inclusion criteria. In total, 748 barriers were identified (frequency count) across the 110 articles. In comparison, 372 facilitators to incident reporting and 118 negative cases were identified. The top two barriers cited were fear of adverse consequences (161, representing 21.52% of barriers) and process and systems of reporting (110, representing 14.71% of barriers). In comparison, the top two facilitators were organisational (97, representing 26.08% of facilitators) and process and systems of reporting (75, representing 20.16% of facilitators).Conclusion A wide range of factors contributing to engagement in incident reporting exist. Efforts that address the current tendency to under-report must consider the full range of factors in order to develop interventions as well as a strategic policy approach for improvement.
Soukup T, Lamb BW, Sarkar S, et al., 2016, Predictors of Treatment Decisions in Multidisciplinary Oncology Meetings: A Quantitative Observational Study, Annals of Surgical Oncology, Vol: 23, Pages: 4410-4417, ISSN: 1534-4681
BACKGROUND: In many healthcare systems, treatment recommendations for cancer patients are formulated by multidisciplinary tumor boards (MTBs). Evidence suggests that interdisciplinary contributions to case reviews in the meetings are unequal and information-sharing suboptimal, with biomedical information dominating over information on patient comorbidities and psychosocial factors. This study aimed to evaluate how different elements of the decision process affect the teams' ability to reach a decision on first case review. METHODS: This was an observational quantitative assessment of 1045 case reviews from 2010 to 2014 in cancer MTBs using a validated tool, the Metric for the Observation of Decision-making. This tool allows evaluation of the quality of information presentation (case history, radiological, pathological, and psychosocial information, comorbidities, and patient views), and contribution to discussion by individual core specialties (surgeons, oncologists, radiologists, pathologists, and specialist cancer nurses). The teams' ability to reach a decision was a dichotomous outcome variable (yes/no). RESULTS: Using multiple logistic regression analysis, the significant positive predictors of the teams' ability to reach a decision were patient psychosocial information (odds ratio [OR] 1.35) and the inputs of surgeons (OR 1.62), radiologists (OR 1.48), pathologists (OR 1.23), and oncologists (OR 1.13). The significant negative predictors were patient comorbidity information (OR 0.83) and nursing inputs (OR 0.87). CONCLUSIONS: Multidisciplinary inputs into case reviews and patient psychosocial information stimulate decision making, thereby reinforcing the role of MTBs in cancer care in processing such information. Information on patients' comorbidities, as well as nursing inputs, make decision making harder, possibly indicating that a case is complex and requires more detailed review. Research should further define case complexity a
Soukup Ascencao T, Petrides VK, Lamb BW, et al., 2016, The anatomy of clinical decision-making in multidisciplinary cancer meetings: a cross-sectional observational study of teams in a natural context, Medicine, Vol: 95, ISSN: 0025-7974
Abstract: In the UK, treatment recommendations for patients with cancer are routinely made by multidisciplinary teams in weekly meetings. However, their performance is variable.The aim of this study was to explore the underlying structure of multidisciplinary decision-making process, and examine how it relates to team ability to reach a decision.This is a cross-sectional observational study consisting of 1045 patient reviews across 4 multidisciplinary cancer teams from teaching and community hospitals in London, UK, from 2010 to 2014. Meetings were chaired by surgeons.We used a validated observational instrument (Metric for the Observation of Decision-making in Cancer Multidisciplinary Meetings) consisting of 13 items to assess the decision-making process of each patient discussion. Rated on a 5-point scale, the items measured quality of presented patient information, and contributions to review by individual disciplines. A dichotomous outcome (yes/no) measured team ability to reach a decision. Ratings were submitted to Exploratory Factor Analysis and regression analysis.The exploratory factor analysis produced 4 factors, labeled “Holistic and Clinical inputs” (patient views, psychosocial aspects, patient history, comorbidities, oncologists’, nurses’, and surgeons’ inputs), “Radiology” (radiology results, radiologists’ inputs), “Pathology” (pathology results, pathologists’ inputs), and “Meeting Management” (meeting chairs’ and coordinators’ inputs). A negative cross-loading was observed from surgeons’ input on the fourth factor with a follow-up analysis showing negative correlation (r = -0.19, P < 0.001). In logistic regression, all 4 factors predicted team ability to reach a decision (P < 0.001).Hawthorne effect is the main limitation of the study.The decision-making process in cancer meetings is driven by 4 underlying factors representing the complete patient prof
Kapur N, Parand A, Soukup T, et al., 2016, Aviation and healthcare: a comparative review with implications for patient safety., JRSM Open, Vol: 7, ISSN: 2054-2704
Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented. Key safety-related domains that emerged included Checklists, Training, Crew Resource Management, Sterile Cockpit, Investigation and Reporting of Incidents and Organisational Culture. We conclude that whilst healthcare has much to learn from aviation in certain key domains, the transfer of lessons from aviation to healthcare needs to be nuanced, with the specific characteristics and needs of healthcare borne in mind. On the basis of this review, it is recommended that healthcare should emulate aviation in its resourcing of staff who specialise in human factors and related psychological aspects of patient safety and staff wellbeing. Professional and post-qualification staff training could specifically include Cognitive Bias Avoidance Training, as this appears to play a key part in many errors relating to patient safety and staff wellbeing.
Hughes J, Soukup T, Mace A, et al., 2015, Head and Neck Cancer Multidisciplinary Team Meeting Quality Improvement: The Impact of a New Patient Information Delivery Tool, British Association of Head & Neck Oncologists (BAHNO)
Sarkar S, Arora S, Soukup T, et al., 2014, Variability in the quality of decision-making processes in urology multidisciplinary teams compared to other cancer specialties, Annual Scientific Meeting of the British-Association-of-Urological-Surgeons (BAUS), Publisher: WILEY-BLACKWELL, Pages: 31-32, ISSN: 1464-4096
Gandamihardja T, McInerney S, Soukup T, et al., 2014, 14. Improving team working within a breast MDT: An observational approach, European Journal of Surgical Oncology, Vol: 40, Pages: 604-604, ISSN: 0748-7983
Sarkar S, Arora S, Soukup T, et al., 2014, 878 A multi-centre study evaluating performance of multidisciplinary teams: Urology vs the top cancer killers, European Urology Supplements, Vol: 13, Pages: e878-e878a, ISSN: 1569-9056
Sarkar S, Arora S, Soukup T, et al., 2014, Variability in the quality of decision-making processes in urology multidisciplinary teams compared to other cancer specialties, Conference on Changing Paradigms in Urology (UROFAIR), Publisher: WILEY-BLACKWELL, Pages: 27-28, ISSN: 1464-4096
Soukup T, Sarkar S, Arora S, et al., 2014, Predictors of Treatment Decisions in Cancer MDT meetings, 8th International Meeting on Behavioural Sciences Applied to Surgery and Acute Settings
Sarkar S, Lamb BW, Jalil RT, et al., 2014, Improving multidisciplinary team working in urological oncology, Modern Breakthroughs and Future Advances, Editors: Patel, Mould, Joseph, Delaney
Howell P, Soukup-Ascencao T, Davis S, et al., 2011, Comparison of alternative methods for obtaining severity scores of the speech of people who stutter, CLINICAL LINGUISTICS & PHONETICS, Vol: 25, Pages: 368-378, ISSN: 0269-9206
Soukup T, Howell P, Leung D, et al., 2010, Usage Factors and Language Development, Lexical Access and Usage Properties
<p>Background: Evidence-based tools are necessary for scientifically improving the way cancer multidisciplinary tumor boards (MTBs) work. Such tools are available but can be difficult to use. We sought to develop a robust observational assessment tool for use by healthcare professionals to improve how MTBs work in everyday practice.Participants and methods: We conducted a retrospective cross-sectional observational study in the United Kingdom between September 2015 and July 2016. Three tumor boards from three teaching hospitals were recruited with 44 members overall. Six weekly meetings (146 consecutive cases) were video recorded and scored using the validated MODe tool. Data were subjected to reliability and validity analysis in the current study for the purposes of developing a shorter version of MODe.Results: In phase 1, a reduction in the original items of MODe was achieved through two focus group meetings with expert assessors based on previous research. Twelve original items were reduced to six domains and have received full agreement by the assessors. In Phase 2, the six domains were subjected to item reliability, convergent validation, and internal consistency testing against MODe-Lite global score, MODe global score, and the individual items of MODe. Significant positive correlations were evidenced across the six domains (p&lt;0.01), providing indication of good reliability and validity. In phase 3, feasibility and high inter-assessor reliability in the use of the tool by two clinical assessors was achieved. A final set of 6 domains, measuring clinical input, holistic input, clinical collaboration, pathology, radiology and management plan were integrated into MODe-Lite.Conclusions: MODe-Lite is an evidence-based tool that can be used by healthcare professionals in everyday practice. It can give cancer MTBs insight into the way they work to facilitate improvements in practice.</p>
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.