Practice Variation in Preoperative MDT Meetings

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

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.

Study Overview

• Status: Completed
• Conditions: Preoperative Care; Multidisciplinary Communication; Patient Care Team
• Intervention / Treatment: Other: Survey

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 54

Contacts and Locations

• Study Contact: Name: Romijn M Boerlage, MD, MSc; Phone Number: +3188 005 8833; Email: preparation@rijnstate.nl
• Study Contact Backup: Name: Jacqueline E Vernooij, MD, MSc, MA

Study Locations

• Netherlands
  • Nijmegen, Netherlands
    • Rijnstate Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

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.

Description

Inclusion Criteria:

• Currently working as anesthesiologist in a Dutch hospital

Exclusion Criteria:

• No informed consent

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Anaesthesiologists in the Netherlands; 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; 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.

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Rijnstate Hospital
• Investigators: Principal Investigator: Carine JM Doggen, PhD, Rijnstate Hospital; Principal Investigator: Benedikt Preckel, MD, PhD, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Study record dates

Study Major Dates

• Study Start (Actual): January 31, 2023
• Primary Completion (Actual): March 31, 2023
• Study Completion (Actual): May 31, 2023

Study Registration Dates

• First Submitted: February 1, 2023
• First Submitted That Met QC Criteria: April 3, 2023
• First Posted (Actual): April 4, 2023

Study Record Updates

• Last Update Posted (Estimated): November 16, 2023
• Last Update Submitted That Met QC Criteria: November 15, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: preoperative; multidisciplinary team meeting; high risk surgical patients
• Other Study ID Numbers: 2022-16058

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data will be made accessible on request after agreement has been received from the entire project group. The principal investigator will communicate data availability with researchers sending the requests.
• IPD Sharing Time Frame: Starting 12 months after publication
• IPD Sharing Access Criteria: Data will be made accessible on request after agreement has been received from the entire project group.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No