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Barriers to communication in multidisciplinary breast cancer teams.

6133 Background: Multidisciplinary teams have been recommended for patient care in breast cancer, with potential benefits including improvements in survival, quality of life and recruitment to clinical trials, and reductions in waiting times and service duplication. The literature highlights potential obstacles which may impede effective functioning of cancer teams, including inter-professional and interpersonal barriers and healthcare system characteristics.


METHODS
Members of multidisciplinary teams in 5 Australian states were surveyed, to assess the impact of potential barriers, including confidentiality; time pressures; individual responsibilities; "group think"; stress due to team membership; lack of support from other disciplines; uncertainty about responsibility for addressing psychosocial concerns; poor patient orientation; facilitation of meetings; inter-professional boundaries; facilities; administrative support; reimbursement; gender biases; hierarchies; terminology; delays due to interruptions; and disparate communication of prognosis.


RESULTS
58 health professionals responded to the questionnaire. The most problematic issues for professionals in the Australian context were: Time pressures reducing the effectiveness of multidisciplinary meetings (65%); Insufficient administrative support (54%); Stress arising from teamwork (45%); Insufficient facilities for team meetings (43%); Lack of reimbursement for time spent in meetings (39%). Issues that were thought to be well-managed included: Patient confidentiality (78.9%); Gender biases not hindering effective communication (77%); Terminology across disciplines not posing a problem (74%); Individual responsibility for patient care not reduced through multidisciplinary teamwork (67%); Facilitation of meetings being appropriate (44%).


CONCLUSIONS
The data highlights that health system barriers are generally perceived to be more important in hampering team performance than interpersonal or interprofessional issues, and will need to be addressed systematically to improve communication in Australian breast cancer teams. No significant financial relationships to disclose.