2. Aims This presentation is intended to provide a brief introduction to MDT-FIT. In it we address the following questions; – What is MDT-FIT? – Why is MDT assessment important? – Why do MDT-FIT? Plus, getting started using MDT-FIT…

3. What is MDT-FIT? MDT-FIT (Feedback for Improving Teamworking) is Trust- run/resourced tool designed to enable cancer MDTs to self- assess and receive feedback on how their team performs against the standards set out in the ‘The Characteristics of an Effective MDT’ (NCAT, 2010, http://www.ncin.org.uk/mdt.).http://www.ncin.org.uk/mdt It was developed with input from over 100 MDTs and designed to be a Team owned process (developmental not judgemental). MDT-FIT is supported by a comprehensive web-based platform and consists of a three stage process to be completed over an 8- 12 week period, with an annual review. The three stages involve: assessment, feedback, discussion

4. MDT-FIT processes 1a: Team self- assessment: online survey completed by each MDT member 1b: Independent assessment: observational assessment of at least one MDT meeting 2: Feedback report shared: synthesis of MDT members and independent observers’ assessments, sent to all MDT members and their facilitator 3a: Preparatory meeting: MDT lead and facilitator may meet to discuss feedback 3b: Facilitated team discussion of feedback: team agree actions in a facilitated meeting 3c: Trust management discussion: to address issues requiring Trust input Actions implemented and reviewed

5. 1a: Team self-assessment: Each member will be sent an email link to register and complete the survey* Survey takes around 15mins to complete 1b: Independent assessment: Observers are independent Trust managers or clinicians (i.e. outside the team/not be involved with team members on day to day basis) Observers should have experience/good knowledge of MDT working Provided with an assessment criteria *For details about the development, reliability and validity of the survey see, Taylor C, Brown K, Lamb B, Harris J, Sevdalis N, Green, JSA. Development and testing TEAM (Team Evaluation and Assessment Measure), a self-assessment tool to improve cancer multidisciplinary teamwork. Annals of Surgical Oncology. 2012; 19: 4019-4027

6. 2: Feedback report shared: Synthesis of MDT members/independent observers’ assessments Emailed to MDT members/facilitator (at least 7 days before team facilitated discussion) No interpretation of the data- that’s up to the team to decide what to discuss! Remember- the team owns the report. It’s the teams decision whether they share their report more widely with Trust colleague Team members should all read the report before the next stage…

7. 3a: Preparatory meeting: Useful for MDT lead/facilitator to have short meeting (phone or face to face) to discuss provide some context/details about the MDT 3b: Facilitated team discussion of feedback: 1 hour meeting Senior Trust clinician or manager with facilitation skills, helps the whole team to discuss feedback and agree an action plan Decide which actions need Trust management input to resolve 3c: Trust management discussion: Lead/ facilitator and others meet with Cancer Services Manager and Cancer Clinical Lead to share action plan and help address issues outside of the team’s remit (i.e. requiring Trust input to resolve)

8. Actions implemented and reviewed Over the next year actions are implemented Action plans should be…. S pecific: clear/unambiguous M easurable: to assess progress A chievable: it may stretch you, but still within capacity R elevant: actions that matter T ime-specific: commit to a time frame Progress of implementation should be reviewed at regular intervals Named MDT members are responsible for taking individual actions forward

9. Why is assessment of MDT-working important? Some aspects of MDT working are assessed - adherence to these standards, within and between tumour types, is variable (NCAT, 2012). Other aspects of teamworking are not as easily translated to measurable standards, but may impact on the quality of patient care (Lamb et al, 2011a; Lamb et al, 2011b) : e.g. leadership, the patient-centredness of the decision- making process, inclusiveness and quality of communication between team members. Variation in these factors has been related to poorer patient (and staff) experience and poorer clinical outcomes (Blazeby et al 2006, Stalfors et all 2007, Lanceley et al, 2008) A survey of cancer team members showed that they would like a tool to enable them to self-assess their team-work and meetings; MDT-FIT seeks to provide this tool (Taylor et al, 2009)

10. Why do MDT-FIT? MDT-FIT WORKS most MDT members who have taken part (74%) expressed positive views about MDT-FIT and its capacity to facilitate improvements to team-work On average teams agree 8 actions for improvement MINIMAL TIME AND NHS RESOURCE The average team member completes the self-assessment, reads the feedback report and participates in the facilitated team discussion (about 90-120 mins in total). MDT-FIT makes use of existing Trust expertise to support the process QUALITY ASSURANCE For MDTs (and at an organisational level), MDT-FIT provides a useful mechanism for Trusts to support their MDTs to assess their clinical governance and quality standards.

11. Getting started using MDT-FIT All members agree a date for the facilitated team discussion (at least 6 weeks in advance) Suitable facilitator/observer identified by Trust Champion Email addresses provided by team to Trust champion Facilitator/MDT lead invited to register online/agree team details Team members invited to register and complete survey Observer invited to register and complete their assessment

12. For more details see www.greencrossmedical.com or http://www.youtube.com/watch?v =8bWI2ieSjWE www.greencrossmedical.com http://www.youtube.com/watch?v =8bWI2ieSjWE Last updated Dec 2013