Multi-Disciplinary Team (MDT) Assessment Proforma
VSGBI Framework for Improving the Results of Elective AAA Repair (2009) Quality Standard:
All elective AAA procedures should be reviewed preoperatively in an MDT that includes surgeon(s) and radiologist(s) as a minimum. Fitness issues that may affect whether open repair or EVAR is offered must be considered. ALL CT scans and patients to be discussed and decisions made regarding Open or Endovascular repair, decision recorded.
Vascular Anaesthesia Society's (VASGBI) survey of vascular anaesthetic practice in the U.K:
- 91% of anaesthetists have regular vascular sessions
- Very few anaesthetists have specific pathways for AAA preoperative assessment
There a clear need for a formal process for anaesthetic involvement in preoperative assessment in vascular practice. To read more outcomes from the survey click here. As part of the AAA QIP we are working within regions aound the U.K.to develop a more formal process for anaesthetic involvement in AAA repair.
An anaesthetist with interest in vascular anaesthesia should be consulted before deciding to admit for surgery. To achieve best practice, centres should move towards anaesthetists attending MDT meetings. If this is not currently achievable applications for sessions for anaesthetists to attend the MDTs should be supported. The AAA QIP recognises that anaesthetists attending MDTs is not always practical. We have ammended a MDT proforma from the Sheffield Vascular Institute. This forms best practice to capture MDT assessment and to encourage and document anaesthetic involvement in the decision to proceed to intervention.
The proforma is provided below and we encourage centres who do not formally involve anaesthetists to adopt this to drive up the quality of care for AAA patients.Download Elective AAA MDT Care Pathway (Updated July 2011)