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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. 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

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  1. Best Practice for the MDTM Process Lal Senaratne MS, FRCS, D.Phil (Oxon) Consultant Vascular Surgeon East Kent Hospitals University NHS Foundation Trust

  2. What I will do . . . • Describe what we do in Kent • Raise some issues • Conclude Re:Best Practice

  3. Our patch . . . Medway Canterbury

  4. What we have . . . • 2 Centres • Network solution • Joint MDTM for AAAs

  5. Who is in our MDTM . . . • Vascular Surgeons • Interventional Radiologists • Vascular Anaesthetists • Junior doctors/trainees • Vascular Nurse practinoners • Secretary • Others

  6. 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

  7. What happens at our MDTM … • Play video clip

  8. Some of the kit we use . . .

  9. Some of the kit we use . . .

  10. 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)

  11. Best Practice • Right Team • Right information • Right patient • Consensus as far as possible • Tertiary opinion Right decision

  12. Thank you Any questions?

  13. Notes

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