P148: The introduction of a pre-multidisciplinary team triage meeting as an approach to improving the effectiveness of the breast multidisciplinary team meeting
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Several specialist teams are involved in the management of patients with urological cancer. These specialists have been brought together as a multidisciplinary team to discuss, plan and deliver care to patients in an effective, patient-centred approach. This article discusses the benefits of this approach and ways in which multidisciplinary team working can be optimized.
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This chapter contains section titled: Introduction Background: the development of multidisciplinary teams in cancer services Multidisciplinary teams in colorectal cancer The function of the MDT Evidence for improved outcome/benefits Limitations of the multidisciplinary team's process Future developments in MDT management of colorectal cancer Conclusions
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National guidance for cancer multidisciplinary teams recommends streamlining cases according to clinical complexity and guidelines. This article explores how the existing knowledge base and resources, accumulated since the introduction of multidisciplinary teams, can help to improve their effectiveness.
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It is widely recognized that a multidisciplinary team is effective in the management of diabetic foot ulcers. Contrary to developed countries, multidisciplinary diabetic foot care teams and/or clinics have not been constructed in most centres in developing countries. The aim of this study was to present our data regarding amputation rates and profiles before and after starting the Dokuz Eylul University multidisciplinary diabetic foot care team.This study includes data from diabetic foot ulcer episodes which were managed in Dokuz Eylul University Hospital between January 1999 and January 2008. The data was collected prospectively during a minimum follow-up of 6 months in all ulcers. After January 2002, management of ulcers was coordinated by the diabetic foot care team (n=437). Amputation rates were compared to those who were admitted before January 2002 (n=137).Overall amputation and minor amputation rates were similar for both periods. However, major amputations were observed to be decreased after starting the Dokuz Eylul University multidisciplinary diabetic foot care team (20.4% vs. 12.6%, p=0.026).Our results demonstrated that major amputation rates can be reduced by team work. Formation of multidisciplinary diabetic foot care teams and clinics should be encouraged in Turkey.
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Abstract All members of the multidisciplinary team aim to enable the person with osteoporosis to cope with the condition and to reduce the risk of fracture. People with osteoporosis are likely to come into contact with different healthcare professionals who can help address many of the problems encountered with the condition. This chapter gives a brief description of some members of the multidisciplinary team and their roles.
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To describe the outcomes of gastroschisis (GS) patients managed with and without a multidisciplinary team during the postoperative period in Canada.The Canadian Pediatric Surgery Network (CAPSNet) collects patient data from all Canadian tertiary perinatal centres. The outcomes of 396 GS patients born between 2005 and 2009 who were managed with and without a multidisciplinary team were analyzed.Significantly more parenteral nutrition (PN) days (P=0.003) and longer lengths of stay (P=0.018) were observed among patients in centres with multidisciplinary teams. Higher mortality rate and earlier death were observed in centres without multidisciplinary teams, especially for high-risk patients, although this was not statistically significant. With regard to low-risk patients, those in centres with multidisciplinary teams had significantly more PN days (P=0.019).GS patients managed by multidisciplinary teams had significantly more PN days and longer lengths of stay compared with patients who were not managed by multidisciplinary teams. This difference may be due to improved survival of high-risk patients in centres with multidisciplinary teams, and a uniform feeding approach for all patients.Décrire l’évolution des patients ayant un gastroschisis (GS) traités ou non par une équipe multidisciplinaire pendant la période postopératoire au Canada.Le Réseau canadien de chirurgie pédiatrique (CAPSNet) collige les données sur les patients de tous les centres périnatals de soins tertiaires au Canada. L’évolution de 396 patients ayant un GS nés entre 2005 et 2009 et qui ont été traités ou non par une équipe multidisciplinaire a été analysée.Les patients hospitalisés dans des centres dotés d’équipes multidisciplinaires passaient considérablement plus de jours sur alimentation parentérale (AP) (P=0,003) et étaient hospitalisés plus longtemps (P=0,018). Bien que ce résultat ne soit pas significatif, le taux de mortalité était plus élevé et les décès, plus rapides dans les centres ne disposant pas d’une équipe multidisciplinaire, surtout chez les patients à haut risque. Pour ce qui est des patients à faible risque, ceux qui étaient traités dans des centres disposant d’une équipe multidisciplinaire passaient considérablement plus de jours sur AP (P=0,019).Les patients ayant un GS traités par une équipe multidisciplinaire passaient considérablement plus de jours sur AP et étaient hospitalisés plus longtemps que ceux qui n’étaient pas traités par une telle équipe. Cette différence peut être attribuable au meilleur taux de survie des patients à haut risque dans les centres disposant d’équipes multidisciplinaires et à une approche uniforme en matière d’alimentation pour tous les patients.
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The coronavirus disease 2019 pandemic has escalated clinical needs while interrupting regular processes and straining resources. Striving to deliver optimal care to infected patients with respiratory failure, Rush University Medical Center in Chicago created a multidisciplinary team to provide manual prone positioning safely and efficiently. Team members' experiences, which they shared through a survey, help to illustrate the advantages of a multidisciplinary approach and suggest opportunities to enhance the effectiveness of such a team.
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This chapter contains sections titled: Living with liver disease Effective team working Consent to treatment Members of the multidisciplinary team Roles within the multidisciplinary team Shared-care protocols for patient management Psychological support Nutritional support References
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