Abstract
Aim
Multidisciplinary team (MDT) management of complex bone and joint infections (BJI) is increasingly implemented but studies evaluating this approach are scarce. We assessed the effectiveness of our MDT by analyzing the adherence to its treatment decisions.
Method
A cohort study was conducted comprising patients with complex BJI of which the management was discussed during MDT meetings between 2015 and 2022 in a tertiary care academic hospital. Patient characteristics and MDT data were obtained from electronic patient records.
Results
The analysis included 1321 MDT case decisions on 509 patients. During the study period, the number of patients discussed by the MDT increased from 2.7 to 5.5 per meeting. The percentage of discussed patients with BJI other than prosthetic joint infections (PJI) increased from 26% to 52%. The overall adherence rate to MDT decisions was 92.1%. Reasons for non-adherence were disagreement with the MDT whether cure was achieved or not (34%), new clinical information that was not available during the MDT meeting (12%), preference for suppressive antibiotic treatment over surgery (8%) or not recorded in the patient file (46%).
Conclusions
Over the years, the MDT meeting content expanded from mainly PJI to all complex BJI. The high adherence rate to MDT decisions was indicative of an effective MDT. Analysis of adherence is a useful tool to evaluate an MDT and can be used to improve its quality. Different aspects of an MDT need to be evaluated to fully determine its impact and to help improve the care for patients with complex BJI.
