Construction And Application Of Multidisciplinary Treatment(MDT)model Evaluation Index System

Objective: This study intends to establish an MDT model evaluation index system,and apply this evaluation index system to the MDT working group of a hospital to conduct an overall evaluation of its work development,score each dimension of the index,and summarize the effectiveness of its MDT model.Existing problems were found and corresponding countermeasures and suggestions were put forward to provide a reference for the clinical promotion and management of the multidisciplinary mode,as well as the prevention and control and management of tumor diseases.Methods: 1.Literature research method and qualitative interview method: use the database to conduct literature review,combine the qualitative interview method,adopt the opinions of various experts to modify and improve the alternative indicators,and build a preliminary framework for a multidisciplinary evaluation index system;2.Experts Consulting method:According to the selection principle,18 experts were selected,with two rounds of expert consultation on the evaluation index framework.The reliability of the expert consultation results was evaluated by calculating the expert positive coefficient,the expert authority coefficient and the degree of expert coordination;3.Analytic Hierarchy Process: by constructing The weights of the evaluation indicators are determined by comparing the matrices between the indicators and calculating the weight vector.The consistency test is conducted,and finally the combined weight of the overall evaluation index system is calculated by the product method 4.Empirical research: Select three sample MDT groups of S hospital,collect data of various dimensions of evaluation indicators through observation method,interview method and questionnaire survey method,and evaluate and compare their development.5.Data processing and analysis: According to the above description,use SPSS 24.0 to manage the data as needed,and use Excel 2017 to calculate the weight vector and index score.Results: 1.The initial framework of the evaluation indicators of the MDT model was formed: its main dimensions covered 4 aspects: system design,system operation,system effect and satisfaction.The basic composition items include 10 aspects: institutional responsibilities,human resources,funds,facilities and equipment,medical quality,medical safety,treatment effect,radiation capacity,medical efficiency and patient satisfaction.2.Expert consultation results: The positive coefficients of experts in both rounds were greater than 90%;the authority coefficient was 0.86 in the first round and 0.83 in the second round;the overall coordination coefficient was0.208 in the first round and 0.232 in the second round.Through the second round of expert consultation,the coefficients of variation of indicators at all levels were between 0.052 and 0.188,all less than 2.After two rounds of expert consultation,the MDT model evaluation index system was adjusted to 4first-level indicators,12 second-level indicators and 32 third-level indicators.3.Determination of the weight of the evaluation index system: The weight difference between the first-level indexes is not large,and the index "system operation" accounts for the largest weight.Among them,the weight of system design dimension is 25.086%,the weight of system operation dimension is25.430%,the weight of system effect dimension is 25.086%,and the weight of satisfaction dimension is 24.399%.4.Application of the evaluation index system: This evaluation index system is used to demonstrate the medical management value of the multidisciplinary diagnosis and treatment model of S hospital.The evaluation results show that the overall implementation of the MDT model in S hospital is relatively optimistic.Among the three sample MDT groups,the breast cancer group had the best overall score with 76.327 points,followed by the inflammatory bowel disease group with 69.706 points and the digestive tract tumor group with the lowest score of 61.111 points.In the dimensions of system design,system operation and system effect,the scores of the three groups are quite different,especially in the dimension of system operation.The scores of the three groups in the satisfaction dimension were the same.Conclusion: 1.The index system constructed in this study evaluates the development of the multidisciplinary diagnosis and treatment model from four dimensions: system design,system operation,system effect and satisfaction.Good;2.The MDT model of S hospital has been implemented for nearly four years,the prototype of the model has been established,and the supporting system has been continuously improved,and it has reflected its own characteristics and created the advantages of diagnosis and treatment.There are differences in the work of the four sample MDT groups,and the supervision and management system,incentive assessment mechanism,follow-up follow-up,publicity and operation quality still need to be improved.It is recommended to introduce management tools to strengthen the management of MDT,strengthen implementation supervision,improve the incentive assessment mechanism,establish a systematic patient tracking and follow-up system,increase publicity efforts,and improve the quality of multidisciplinary diagnosis and treatment operations,so as to continuously improve the level of diagnosis and treatment services and further improve patients’ medical experience..The evaluation index system is based on the relevant national plans,norms,and guidelines,with clear levels and comprehensive index coverage.