Pritesh S Morar1,2, Nick Sevdalis3, Janindra Warusavitarne1,2, Ailsa Hart1,2, James Green4, Cathryn Edwards5, Omar Faiz1,2. 1. Surgical Epidemiology Trials and Outcomes Centre, St Marks Hospital, Harrow, UK. 2. Department of Surgery and Cancer, Imperial College, London, UK. 3. Health Services & Population Research, Kings College, London, UK. 4. Department of Urology, Whipps Cross, London, UK. 5. Department of Gastroenterology, South Devon NHS Foundation Trust, Torbay, UK.
Abstract
OBJECTIVE: To obtain a specialist-based consensus on the aims, format and function for MDT-driven care within an inflammatory bowel disease (IBD) service. DESIGN: This was a prospective, multicentre study using a Delphi formal consensus-building methodology. SETTING: Participants were recruited nationally across 13 centres from July to August 2014. PARTICIPANTS: 24 participants were included into the Delphi Specialist Consensus Panel. They included six consultant colorectal surgeons, six gastroenterologists, five consultant radiologists, three consultant histopathologists and 4 IBD nurse specialists. INTERVENTIONS: Panellists ranked items on a Likert scale (1=not important to 5=very important). Items with a median score >3 were considered eligible for inclusion. MAIN OUTCOME MEASURES: Consensus was defined with an IQR ≤1. Consensus on categorical responses was defined by an agreement of >60%. RESULTS: A consensus on items (median; IQR) that described the aims of the MDT-driven care that were considered very important included: advance patient care (5;5-5), provide multidisciplinary input for the patient's care plan (5;5-5), provide shared experience and expertise (5;5-5), improve patient outcome (5;5-5), deliver the best possible care for the patient (5;5-5) and to obtain consensus on management for a patient with IBD (5;4-5). A consensus for being a core MDT member was demonstrated for colorectal surgeons (24/24), radiologists (24/24), gastroenterologists (24/24), nurse specialists (24/24), dieticians (14/23), histopathologists (21/23) and coordinators (21/24). CONCLUSIONS: This study has provided a consensus for proposed aims, overall design, format and function MDT-driven care within an IBD service. This can provide a focus for core members, and aid a contractual recognition to ensure attendance and proactive contribution.
OBJECTIVE: To obtain a specialist-based consensus on the aims, format and function for MDT-driven care within an inflammatory bowel disease (IBD) service. DESIGN: This was a prospective, multicentre study using a Delphi formal consensus-building methodology. SETTING: Participants were recruited nationally across 13 centres from July to August 2014. PARTICIPANTS: 24 participants were included into the Delphi Specialist Consensus Panel. They included six consultant colorectal surgeons, six gastroenterologists, five consultant radiologists, three consultant histopathologists and 4 IBD nurse specialists. INTERVENTIONS: Panellists ranked items on a Likert scale (1=not important to 5=very important). Items with a median score >3 were considered eligible for inclusion. MAIN OUTCOME MEASURES: Consensus was defined with an IQR ≤1. Consensus on categorical responses was defined by an agreement of >60%. RESULTS: A consensus on items (median; IQR) that described the aims of the MDT-driven care that were considered very important included: advance patient care (5;5-5), provide multidisciplinary input for the patient's care plan (5;5-5), provide shared experience and expertise (5;5-5), improve patient outcome (5;5-5), deliver the best possible care for the patient (5;5-5) and to obtain consensus on management for a patient with IBD (5;4-5). A consensus for being a core MDT member was demonstrated for colorectal surgeons (24/24), radiologists (24/24), gastroenterologists (24/24), nurse specialists (24/24), dieticians (14/23), histopathologists (21/23) and coordinators (21/24). CONCLUSIONS: This study has provided a consensus for proposed aims, overall design, format and function MDT-driven care within an IBD service. This can provide a focus for core members, and aid a contractual recognition to ensure attendance and proactive contribution.
Entities:
Keywords:
Health Service Research; Ibd; Inflammatory Bowel Disease
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