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Multidisciplinary team meetings in urogynaecology

International Urogynecology Journal volume 26, pages 1221–1227 (2015)Cite this article

Abstract

Introduction and hypothesis

The concept of multidisciplinary team (MDT) is well accepted in the current National Health Service (NHS) and is considered good practice for the management of chronic conditions. There has been a recent drive to have MDTs in managing women with incontinence and complex prolapse as a result of recommendations by National Institute for Health and Care Excellence (NICE) guidance, Medicines and Healthcare Products Regulatory Agency (MHRA) etc. Currently, there are no data on the outcome of case discussion at urogynaecology MDTs. The aim of this study was to review the clinical impact of discussion of a select group of cases at an urogynaecology MDT and review the clinical literature to justify the MDT approach.

Methods

MDT proformas of cases discussed from October 2012 to December 2013 were reviewed. Outcomes of the MDT were compared with recommendations at the initial consultation. This included change in management plan, type of surgery and surgeon as well as time delay due to MDT discussion.

Results

One hundred six proformas were available for analysis. Age range was 23–89 (58) years. Average time from clinic visit to MDT discussion was 8.32 + 5.9 days. The MDT recommended a change in management plan in 31 cases (29.3 %), with 11 cases (10.4 %) resulting in alternative surgery and 1 case (0.9 %) with an alternative surgeon. In 18.5 % of cases, MDT discussion formulated the initial management plan.

Conclusions

Case discussions at our MDT provide an effective clinical forum to formulate management plans for complex cases. The decision-making process is made robust, without significant impact on waiting time. Investment in setting up MDTs has financial implications but provides patient benefit.

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Abbreviations

MDT:

Multidisciplinary team

NICE:

National Institute for Health and Care Excellence

MHRA:

Medicines and Healthcare Products Regulatory Agency

BSUG:

British Society of Urogynaeocology

ePAQ-PF:

Electronic personal assessment questionnaire-pelvic floor

PGI-I:

Patient Global Impression of Improvement

STH:

Sheffield Teaching Hospitals

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Conflicts of interest

None.

Authors' contributions

DG was responsible for the conception, design of the study, acquisition, analysis and interpretation of the data. She was substantially involved in the drafting, revision and final approval of the manuscript. SJ was responsible for the conception and design of the study interpretation and analysis of the data as well as drafting, revision and final approval of the manuscript.

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Affiliations

  1. Stepping Hill Hospital, Poplar Grove, Stockport, SK2 7JE, UK

    Deepa Gopinath

  2. Jessop Wing, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, S10 2SF, UK

    Swati Jha

Authors
  1. Deepa Gopinath
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  2. Swati Jha
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Correspondence to Deepa Gopinath.

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Gopinath, D., Jha, S. Multidisciplinary team meetings in urogynaecology. Int Urogynecol J 26, 1221–1227 (2015). https://doi.org/10.1007/s00192-015-2662-4

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  • DOI: https://doi.org/10.1007/s00192-015-2662-4

Keywords

  • Multidisciplinary team
  • MDM
  • MDT
  • Cancer
  • Prolapse
  • Incontinence