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      Multidisciplinary collaboration among young specialists: results of an international survey by the emerging EULAR network and other young organisations

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          Abstract

          Background

          Multidisciplinary collaboration is defined as a collective work involving multiple disciplines and is common in clinical care and research. Our aim was to describe current clinical and research collaboration among young specialists and to identify unmet needs in this area.

          Methods

          An online survey was disseminated by email and social media to members of the EMerging EUlar NETwork, the Young Nephrologists’ Platform, the Paediatric Rheumatology European Society Emerging Rheumatologists and Researchers and the European Academy of Allergy and Clinical Immunology Junior Members.

          Results

          Of 303 respondents from 36 countries, 61% were female, 21% were aged below 30 years and 67% were aged 31–40 years. Young rheumatologists were the most represented (39%), followed by young nephrologists (24%), young paediatricians (20%), young allergologists (11%) then young internists (3%) and 3% other specialities. Collaborations were reported frequently by phone and email, also by various combined clinics while common local multidisciplinary meetings were uncommon. 96% would like to develop clinical research collaborations and 69% basic research collaborations. The majority of young specialists would be interested in online (84%) and/or 1–2 days (85%) common courses including case discussion (81%) and training workshops (85%), as well as webinars recorded with several specialists on a specific disease (96%).

          Conclusions

          This collaborative initiative highlighted wishes from young specialists for developing (1) regular local multidisciplinary meetings to discuss complex patients, (2) clinical research collaboration with combined grants and (3) multidisciplinary online projects such as common courses, webinars and apps.

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          Most cited references10

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          Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: 1. Definitions, objectives, and evidence of effectiveness.

          Teamwork involving multiple disciplines is increasingly emphasized in health research, services, education and policy. The terms multidisciplinary, interdisciplinary and transdisciplinary are increasingly used in the literature, but are ambiguously defined and interchangeably used. This paper is the first of two in a series. It discusses the definitions, objectives, and evidence of effectiveness of such teamwork. The paper is a literature review based on dictionaries, and Google and MEDLINE (1982-2006) searches. Multidisciplinarity draws on knowledge from different disciplines but stays within their boundaries. Interdisciplinarity analyzes, synthesizes and harmonizes links between disciplines into a coordinated and coherent whole. Transdisciplinarity integrates the natural, social and health sciences in a humanities context, and transcends their traditional boundaries. The objectives of multiple disciplinary approaches are to resolve real world or complex problems, to provide different perspectives on problems, to create comprehensive research questions, to develop concensus clinical definitions and guidelines, and to provide comprehensive health services. Multiple disciplinary teamwork has both benefits and drawbacks. The three terms refer to the involvement of multiple disciplines to varying degrees on the same continuum. The common words for multidisciplinary, interdisciplinary and transdisciplinary are additive, interactive, and holistic, respectively. With their own specific meanings, these terms should not be used interchangeably. The more general term "multiple disciplinary" is suggested for when the nature of involvement of multiple disciplines is unknown or unspecified. While multiple disciplinary teamwork is appropriate for complex problems, it is not always necessary in every single project.
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            Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature

            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.
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              Shifting cancer care towards Multidisciplinarity: the cancer center certification program of the German cancer society

              Background Over the last decades numerous initiatives have been set up that aim at translating the best available medical knowledge and treatment into clinical practice. The inherent complexity of the programs and discrepancies in the terminology used make it difficult to appreciate each of them distinctly and compare their specific strengths and weaknesses. To allow comparison and stimulate dialogue between different programs, we in this paper provide an overview of the German Cancer Society certification program for multidisciplinary cancer centers that was established in 2003. Main body In the early 2000s the German Cancer Society assessed the available information on quality of cancer care in Germany and concluded that there was a definite need for a comprehensive, transparent and evidence-based system of quality assessment and control. This prompted the development and implementation of a voluntary cancer center certification program that was promoted by scientific societies, health-care providers, and patient advocacy groups and based on guidelines of the highest quality level (S3). The certification system structures the entire process of care from prevention to screening and multidisciplinary treatment of cancer and places multidisciplinary teams at the heart of this program. Within each network of providers, the quality of care is documented using tumor-specific quality indicators. The system started with breast cancer centers in 2003 and colorectal cancer centers in 2006. In 2017, certification systems are established for the majority of cancers. Here we describe the rationale behind the certification program, its history, the development of the certification requirements, the process of data collection, and the certification process as an example for the successful implementation of a voluntary but powerful system to ensure and improve quality of cancer care. Conclusion Since 2003, over 1 million patients had their primary tumors treated in a certified center. There are now over 1200 sites for different tumor entities in four countries that have been certified in accordance with the program and transparently report their results from multidisciplinary treatment for a substantial proportion of cancers. This led to a fundamental change in the structure of cancer care in Germany and neighboring countries within one decade.
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                Author and article information

                Journal
                RMD Open
                RMD Open
                rmdopen
                rmdopen
                RMD Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2056-5933
                2020
                15 September 2020
                : 6
                : 2
                : e001398
                Affiliations
                [1 ] departmentRheumatology, University of Glasgow Institute of Infection Immunity and Inflammation , Glasgow, UK
                [2 ] departmentRheumatology, Hôpital Pellegrin , Bordeaux, France
                [3 ] Universite de Bordeaux , Bordeaux, France
                [4 ] departmentRoyal National Hospital for Rheumatic Diseases, Royal United Hospital Bath NHS Trust , Bath, UK
                [5 ] departmentDepartment of Pharmacy and Pharmacology, University of Bath , Bath, UK
                [6 ] departmentNephrology Department, Hospital Curry Cabral CHULC , Lisbon, Portugal
                [7 ] NOVA Medical School , Lisbon, Portugal
                [8 ] departmentGlasgow Renal and Transplant Unit, Queen Elizabeth University Hospital , Glasgow, UK
                [9 ] departmentDepartment of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust Hospital , Liverpool, UK
                [10 ] departmentAllergy Unit, Hospital Regional Universitario de Malaga, Instituto de Investigacion Biomedica de Malaga (Ibima)-aradyal ,Malaga, Spain
                [11 ] departmentDepartment of Internal Medicine 3, Division of Rheumatology, Medical University Vienna , Vienna, Austria
                [12 ] departmentArea of Immunology, Universidad de Oviedo , Oviedo, Spain
                [13 ] departmentRheumatology, Leiden University Medical Center , Leiden, Netherlands
                [14 ] departmentRheumatology, Zuyderland Medical Centre Heerlen , Heerlen, Netherlands
                [15 ] departmentDepartment of Medicine, Rheumatology Unit, University of Perugia , Perugia, Italy
                [16 ] departmentRheumatology Research, King’s College London Academic Department of Rheumatology , London, UK
                [17 ] departmentApplied Health Research, University College London , London, UK
                [18 ] NOVA Medical School, Universidade NOVA de Lisboa , Lisbon, Portugal
                Author notes
                Correspondence to Aurélie Najm; aurelie.najm@ 123456gmail.com

                AN and MK contributed equally to this work.

                Author information
                http://orcid.org/0000-0002-6008-503X
                http://orcid.org/0000-0002-8895-6941
                http://orcid.org/0000-0002-0011-5102
                http://orcid.org/0000-0003-1105-5640
                http://orcid.org/0000-0001-6847-3726
                http://orcid.org/0000-0003-1954-0229
                Article
                rmdopen-2020-001398
                10.1136/rmdopen-2020-001398
                7525255
                32934010
                43b4d05c-6297-414c-930d-5ceaf260fa0f
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 16 July 2020
                : 06 August 2020
                : 10 August 2020
                Categories
                Education
                2430
                Short report

                patient care team,epidemiology,health services research

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