The outpatient multi-disciplinary team (MDT) model is an important measure to improve the quality of medical services and enhance patients’ medical experience. The Second Affiliated Hospital of Zhejiang University School of Medicine has explored three types of outpatient MDT models, namely specialized disease model, self-service model, and professor team model, in order to improve the accessibility and coverage of outpatient MDT. Through practice, it has been found that the implementation of multi-type outpatient MDT models can further leverage the advantages of MDT in society, hospitals, and patients. This article will share the experience of building multi-type outpatient multi-disciplinary team models mentioned above.
Objective To explore the application of multi-disciplinary team (MDT) clinics in fetal developmental abnormalities. Methods A retrospective analysis method was used to collect case data of fetal developmental abnormalities and completion of prenatal MDT clinics diagnosis and treatment in pregnant women who were registered in the Department of Obstetrics of West China Second Hospital, Sichuan University between December 2021 and November 2022. The situation of pregnant women and fetuses was summarized and analyzed. Results There were 19362 registered pregnant women, of which 1125 (5.8%) had abnormal fetal development. Among them, 272 (24.2%) received prenatal MDT clinics diagnosis and treatment. Fetal developmental abnormalities were mainly characterized by structural abnormalities (208 cases, 76.5%), with the top three being central nervous system abnormalities, circulatory system abnormalities, and multiple malformations. There were 202 pregnant women who continue to conceive, and 70 cases had undergone induced labor, with an induced labor rate of 25.7%. The top three main causes of induced abortion were multiple malformations, central nervous system abnormalities, and circulatory system abnormalities. After prenatal MDT clinics diagnosis and treatment, the diagnosis of fetal developmental abnormalities in 46 pregnant women were corrected. Conclusion Prenatal MDT clinics are helpful for the early comprehensive evaluation of fetal developmental abnormalities and the determination of diagnosis and treatment plans.
Objective To diagnose and treat a patient with obstructive jaundice and hepatic bile duct tumor by multi-disciplinary team (MDT) and to provide individualized treatment. Methods By MDT model, a patient with obstructive jaundice and hepatic bile duct tumor, who was ever misdiagnosed as hilar cholangiocarcinoma, was discussed. The diagnosis, perioperative period management, and operation scheme were carried out by the MDT. Results After discussion of MDT, the patient was diagnosed as " hepatocellular carcinoma with bile duct tumor thrombi”, not " hilar cholangiocarcinoma”. Although hepatocellular carcinoma with bile duct tumor thrombi was end-stage disease, radical treatment was still considered. A plan of treatment was carried out by the MDT. Firstly, the percutaneous transhepatic cholangial drainage was operated for the predicted reserved half liver to relieve biliary obstruction. Secondly, hemihepatectomy combined with bile duct resection was carried out by the surgery team. The patient had nice postoperative recovery and there was no tumor recurrence after 6-month follow-up after surgery up to now. Conclusions MDT model do not only reduce misdiagnose, but also can provide the best therapeutic regimen and individualized treatment for patient presented with obstructive jaundice and hepatic bile duct tumor.
Lung cancer is a disease with high incidence rate and high mortality rate worldwide. Its diagnosis and treatment mode is developing constantly. Among them, multi-disciplinary team (MDT) can provide more accurate diagnosis and more individualized treatment, which can not only benefit more early patients, but also prolong the survival time of late patients. However, MDT diagnosis and treatment mode is only carried out more in provincial and municipal tertiary hospitals and has not been popularized. This article intends to introduce MDT mode and its advantages, hoping that MDT mode can be popularized and applied.
The misdiagnosis rate and mortality of mesenteric ischemia are high, but with the continuous updating of diagnosis and treatment techniques and treatment concepts in recent years, many patients can get timely and effective treatment. This article starts from the epidemiology, vascular anatomy, etiology, clinical manifestations and classification of mesenteric ischemia, and the progress of diagnosis and treatment under the multidisciplinary diagnosis and treatment mode, and details the research progress of mesenteric ischemia at home and abroad. This paper focuses on the significance of multidisciplinary diagnosis and treatment mode in the diagnosis and treatment of mesenteric ischemia, in order to strengthen the treatment consciousness of mesenteric ischemia and explore a more accurate and effective treatment system. The purpose of this study is to provide some reference for avoiding intestinal infarction and improving the survival rate of intestinal tract.
Multi-disciplinary team（MDT） is a best model to provide the optimal diagnosis and treatment strategy for difficult and complex diseases. It is of great significance to promote the MDT diagnosis and treatment mode for improving the quality of outpatient medical service. This paper briefly introduces the origin, concept and application of MDT at home and abroad, and puts forward the directions that should be paid attention to and solved according to the problems existing in China, including promoting MDT vigorously and creating a good MDT culture. At the same time, we should continue to improve the outpatient MDT management system, develop suitable management plan, management system, workflow, quality control system, performance evaluation system for the hospital, build multi-disciplinary network information platform and establish monitoring mechanisms.
Multi-disciplinary team (MDT) is a leading diagnosis and treatment model widely respected in modern international medical field, which plays an important role in clarifying disease diagnosis, determining treatment direction, and reducing patient time and labor cost. In recent years, China has issued relevant policies to encourage hospitals to vigorously develop MDT. West China Hospital of Sichuan University established a MDT clinic in 2013. Through continuous innovation and bold breakthrough in terms of experience accumulation, clinical resource integration, disciplinary collaboration and other aspects, the hospital breaks the barriers of MDT, timely helps complex severe diseases patients to solve the diagnosis and treatment needs, provides patients with the best personalized treatment plan, and continuously improves the medical experience of patients. Therefore, this article introduces and summarizes the implementation process and experience of MDT outpatient clinic in West China Hospital of Sichuan University.