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

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.