Practice Variation in Preoperative MDT Meetings

Study Overview
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Brief Summary
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The goal of this observational survey study is to evaluate the current practice variations of preoperative multidisciplinary team meetings (MDT meetings) for high risk noncardiac surgical patients. The main questions it aims to answer are: What is the current variation in Dutch hospitals in the practice of preoperative MDT meetings for high risk noncardiac surgical patients? Which facilitators and barriers influence the implementation process of preoperative MDT meetings? Participants are anesthesiologists in Dutch hospitals who will be asked to fill in a one-time survey. One anesthesiologist per anesthesiology department will be asked to fill in the survey. The survey will take approximately 5 to 10 minutes to complete.

Detailed Description
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The number of patients with multiple comorbidities is significantly growing. Medical advances have made it possible to perform challenging surgical interventions to increase life expectancy. Yet, it is this group of patients that has a high risk of complications after a surgical intervention leading to a reduction in their quality of life and self-sustainability. Current European and Dutch guidelines recommend the implementation of preoperative multidisciplinary team (MDT) meetings for high risk noncardiac surgical patients. However, the evidence underlying the guideline recommendations is scarce. Furthermore, the implementation process of a well-functioning MDT meeting can be a challenge and may sometimes lead to no MDT meeting at all. And finally, the guidelines do not specify conditions by who or how the MDT meeting should be done, for example required attending specialties or specific subjects to be discussed. A broad practice variation in preoperative MDT meetings might thus be present and could be a complicating factor in the equal treatment of patients compliant to 'best practice'. The current survey will evaluate practice variation of preoperative MDT meetings for high risk noncardiac surgical patients in the Netherlands and assess possible facilitators and barriers in the implementation process.

Official Title
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Preoperative Multidisciplinary Team Meetings for High Risk Noncardiac Surgical Patients: A Nationwide Survey on Practice Variation, Facilitators and Barriers

Conditions
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Multidisciplinary Communication, Preoperative Care, Patient Care Team

Intervention / Treatment
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* Other: Survey


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Currently working as anesthesiologist in a Dutch hospital Exclusion Criteria: No informed consent
Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Anaesthesiologists in the Netherlands<br>The participants in this study are anesthesiologists in the Netherlands, preferably those in charge of preoperative screening. One anesthesiologist per anesthesiology department may be included. | Other: Survey<br>* 29-item Dutch survey about the implementation and practice variation of preoperative multidisciplinary team (MDT) meetings for high risk noncardiac surgical patients in the Netherlands.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of anaesthesia departments who employ preoperative multidisciplinary team (MDT) meetings for high risk noncardiac surgical patients in Dutch hospitals. | Percentage of anaesthesia departments who employ preoperative multidisciplinary team (MDT) meetings in which an anaesthesiologist is present, for high risk noncardiac surgical patients in Dutch hospitals. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of multidisciplinary team (MDT) meetings per month | An approximate frequency of preoperative multidisciplinary team (MDT) meetings for high risk noncardiac surgical patients per month | Baseline | 
| Number of patients discussed per multidisciplinary team (MDT) meeting | Number of patients discussed per multidisciplinary team (MDT) meeting (average) | Baseline | 
| Duration of multidisciplinary team (MDT) meeting in minutes | Duration of multidisciplinary team (MDT) meeting in minutes (average) | baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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multidisciplinary team meeting, high risk surgical patients, preoperative