# Audit whether tumour board recommendations were actually carried out

Source: https://onco.cc/ideas/idea-acc-tumour-board-implementation-audit/  
OnCo record `idea-acc-tumour-board-implementation-audit` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Hospitals hold weekly meetings to decide each patient's plan but rarely check what happened afterwards. A simple loop that records the recommendation and checks it against what was done would catch dropped plans.

## Summary

Studies suggest that a meaningful minority of multidisciplinary team recommendations are not implemented, for reasons ranging from patient choice to lost referrals, and few boards track this. Recording each recommendation as structured data and reconciling it automatically with subsequent orders and treatment records would produce an implementation rate per team, with reasons for deviation, closing the loop on the most important decision point in cancer care.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Boards that receive quarterly implementation audits will reduce unexplained non-implementation of recommendations by at least half within a year.
- Rationale: Closing feedback loops is basic quality engineering; multidisciplinary boards are one of the few places in medicine where the decision is documented but the outcome is not systematically checked.
- Proposed test: Introduce structured recommendation capture and reconciliation in ten hospitals and measure implementation rates and reasons over four quarters.
- Maturity: speculative
- Actor: clinic

## Sources

- Bottleneck evidence (Fragmented care and guideline gaps): Hanna et al., Mortality due to cancer treatment delay: systematic review and meta-analysis (BMJ 2020): https://doi.org/10.1136/bmj.m4087

## Connected records

- ideas: [Live guideline-concordance dashboards for every tumour board, generated from the record](https://onco.cc/ideas/idea-acc-guideline-concordance-dashboards/)
- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/)
- key papers: [Mortality due to cancer treatment delay: systematic review and meta-analysis](https://onco.cc/key-papers/paper-hanna-bmj/)

---
JSON: https://onco.cc/api/v1/entities/idea-acc-tumour-board-implementation-audit.json