JMIR Publications

ABSTRACT

Background:

Tumor boards constitute the main consensus and clinical decision-making body of multidisciplinary teams (MDTs) in cancer care. The increasing clinical complexity (e.g. targeted therapies, multimodal treatments) and the progressive incorporation of new areas of intervention (e.g. survivorship care) require that they play a central role in all cancer processes. However, despite the fact that there are frameworks designed to evaluate their quality, there are few 2.0 tools that facilitate the evaluation of the effectiveness of teamwork and, for the specific case of the Spanish National Health System (SNHS), none have been developed or adapted.

Objective:

Analyze the development and validation of the AEMAC Program as a virtual self-assessment model of quality for cancer MDTs, testing its metric properties and checking its acceptability and usability as a 2.0 tool.

Methods:

An Observational study of design and validation of a web tool based on three phases. Regarding the first phase of research, a review of the available scientific evidence was conducted and a qualitative case study was carried out based on good practices in multidisciplinary care in the context of the SNHS (n = 4 centers and 28 professionals interviewed). This made it possible to define aspects and quality criteria for the work of the MDTs and these to be discussed and validated by a group of experts. The second phase involved the technological development of a web application accessible from any mobile device. The third phase comprised the piloting and validation of the tool to test the acceptability and usefulness of AEMAC, based on three pilot tests (n = 15 tumor boards, 243 professionals).

Results:

The results obtained included both the development of the tool and its validation. The design was based on a self-assessment model of the MDTs considering 5 aspects that included 25 quality components, each evaluated by three degrees of development. The evaluation process was formulated in three phases managed entirely from the web application, namely, individual self-assessment, group prioritization process and establishment of an improvement plan. Internal consistency was calculated using Cronbach's Alpha (0.86) and McDonald’s Omega (0.88) and fit indices (CFI between 0.95 and 1 in the five aspects analyzed; GFI between 0.97 and 0.99). The mean overall satisfaction with the AEMAC program was 7.6 out of 10. The content of the tool (mean of 7.6 out of 10) was considered consistent with the reality of the tumor boards.

Conclusions:

The results obtained during the period of research and piloting of the AEMAC Program show that it has an appropriate structure and metric properties and it is, therefore, possible to implement it in a real context. As a virtual tool, it contributes to identifying key aspects for MDTs such as the quality of collaboration and communication, leadership or the organizational environment, all of which decisively demonstrate its effectiveness. The use of this 2.0 tool could be generalized to other hospitals.