Optimizing multidisciplinary team meetings in vascular surgery: Insights and lessons from practice

Area of Science:

• Vascular Surgery
• Health Services Research
• Clinical Decision-Making

Background:

• Vascular multidisciplinary team meetings (MDTMs) are crucial for complex patient care.
• Assessing the structure, content, and recommendation adherence of vascular MDTMs is essential for optimizing patient outcomes.

Purpose of the Study:

• To describe the structure and content of vascular MDTMs.
• To evaluate the implementation of MDTM recommendations in clinical practice.
• To identify reasons for deviations from MDTM recommendations.

Main Methods:

• Prospective observational cohort study at a tertiary vascular center.
• Utilized the adapted MDT-Metric for the Observation of Decision-making (MDT-MODe) tool.
• Reviewed medical records after 1 year to assess adherence to MDTM recommendations.

Main Results:

• 112 patients across 6 MDTMs were analyzed; discussion time was ~3.5 minutes/patient.
• Imaging reviewed in 97.1% of cases; comorbidities (29.4%), psychosocial factors (11%), and patient perspectives (8%) were less frequently discussed.
• MDTM recommendations were adjusted in 20% of outpatient cases, rising to 43% for interventions; deviations often due to frailty, patient preference, or clinical changes.

Conclusions:

• Vascular MDTMs predominantly focus on procedural and diagnostic aspects, with limited discussion of patient comorbidities and preferences.
• This narrow focus may contribute to discrepancies between MDTM recommendations and clinical adherence.
• Enhancing MDTMs with a holistic approach, including more specialists and dedicated time, may improve recommendation alignment with patient needs and adherence.