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Best Practice for the MDTM Process. Lal Senaratne MS, FRCS, D.Phil (Oxon) Consultant Vascular Surgeon East Kent Hospitals University NHS Foundation Trust. What I will do. Describe what we do in Kent Raise some issues Conclude Re:Best Practice. Our patch. Medway. Canterbury.

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Best practice for the mdtm process

Best Practice for the MDTM Process

Lal Senaratne MS, FRCS, D.Phil (Oxon)

Consultant Vascular Surgeon

East Kent Hospitals University

NHS Foundation Trust


What i will do
What I will do . . .

  • Describe what we do in Kent

  • Raise some issues

  • Conclude Re:Best Practice


Our patch
Our patch . . .

Medway

Canterbury


What we have
What we have . . .

  • 2 Centres

  • Network solution

  • Joint MDTM for AAAs


Who is in our mdtm
Who is in our MDTM . . .

  • Vascular Surgeons

  • Interventional Radiologists

  • Vascular Anaesthetists

  • Junior doctors/trainees

  • Vascular Nurse practinoners

  • Secretary

  • Others


Our mdtm process
Our MDTM process

Reaching threshold in surveillance programme

Incidental

finding

Screen detected

Asymptomatic Aneurysms

Symptomatic Aneurysms

Discussions outside MDTM

Pre-op Ix

MDTM Discussion

Written communication to Pt & GP

Anaesthetic Review

Out pt review

Decision to intervene

Intervention

Open

EVAR





Issues
Issues . . .

  • When there is no consensus

  • When Ix not ready

  • Should symptomatic aneurysms be included?

  • Does it introduce delay?

  • Documentation issues

  • Time wasting! (Needless/endless discussion)


Best practice
Best Practice

  • Right Team

  • Right information

  • Right patient

  • Consensus as far as possible

  • Tertiary opinion

Right decision


Thank you
Thank you

Any questions?



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