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Risk Management Activities in a Lung Cancer Multidisciplinary Team at a Comprehensive Cancer Center: Results of a
Alessandro Morabito1, Edoardo Mercadante2, Paolo Muto3
1Thoracic Medical Oncology, Istituto Nazionale Tumori, IRCCS "Fondazione G. Pascale," Napoli, Italy.
Purpose:
The objective of the study was to highlight sources of harm that could negatively affect the lung cancer multidisciplinary team (MDT) activities to reduce the level of risk of each factor.
Methods:
A modified Delphi approach was used by a board of multi-health care professionals of the lung cancer MDT to identify the main processes, subprocesses, and risk factors of the multidisciplinary pathway of patients with lung cancer. A semiquantitative matrix was built with a five-point scale for probability of harm (likelihood) and severity of harm (consequences) according to the international risk management standards (ISO 31000-2018). The risk level was calculated by multiplying likelihood × consequences. Mitigation strategies have been identified and applied by the MDT to reduce risks to acceptable levels.
Results:
Three main processes (outpatient specialist visit, MDT discussion, and MDT program implementation), eight related subprocesses, and 16 risk factors were identified. Four risk factors (25%) were related to outpatient specialist visit, seven (43.75%) to case discussion, and five (31.25%) to program implementation. Overall, two risk factors were assigned a low-risk level (12.5%), 11 a moderate-risk level (68.75%), one (6.25%) a high-risk level, and two (12.5%) a very high-risk level. After the implementation of mitigation measures, the new semiquantitative risk analysis showed a reduction in almost all hazardous situations: two risk factors (12.5%) were given a very low level, six (37.5%) a low level, seven (43.75%) a moderate level, and one (6.25%) a very high level.
Conclusion:
An interdisciplinary risk assessment analysis is applicable to MDT activities by using an ad hoc risk matrix: if the hazard is identified and monitored, the risk could be reduced and managed in a short time.
Insights
Identifying and managing risks in lung cancer multidisciplinary teams (MDTs) is crucial. This study applied a risk assessment matrix to pinpoint and mitigate harm factors, significantly reducing overall risk levels for improved patient care pathways.
Area of Science:
- Healthcare Management
- Oncology
- Risk Management
Background:
- Multidisciplinary team (MDT) activities are vital in lung cancer care.
- Potential sources of harm can negatively impact MDT effectiveness.
- Proactive risk identification and mitigation are essential for optimal patient outcomes.
Purpose of the Study:
- To identify potential hazards affecting lung cancer multidisciplinary team (MDT) activities.
- To quantify the risk level associated with identified factors.
- To implement strategies for risk reduction in lung cancer care pathways.
Main Methods:
- A modified Delphi approach involving multi-healthcare professionals from lung cancer MDTs.
- Utilized a semiquantitative risk assessment matrix based on ISO 31000-2018 standards (likelihood x consequences).
- Identified key processes, subprocesses, and 16 specific risk factors within the lung cancer patient pathway.
Main Results:
- Identified 16 risk factors across outpatient visits, MDT discussion, and program implementation.
- Initially, 12.5% of risks were moderate, 68.75% moderate, 6.25% high, and 12.5% very high.
- Post-mitigation, risk levels decreased, with 12.5% very low, 37.5% low, 43.75% moderate, and 6.25% very high.
Conclusions:
- Interdisciplinary risk assessment using a dedicated matrix is effective for MDT activities.
- Proactive identification and monitoring of hazards can lead to reduced and manageable risks.
- This approach supports timely risk management in lung cancer care pathways.
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