Research On Surgical Safety Assessment Model Based On Multidisciplinary Consultation

Background:With the continuous refinement of clinical sub-subjects,all professional physicians on the continuous deepening of the medical knowledge,it is often difficult to meet the needs of patients with critical or critically ill patients or patients with multiple diseases.Three levels a general hospital has a number of professional departments of the technical force,to provide difficult to critically ill patients with multidisciplinary,comprehensive personalized treatment or the best treatment program.Nowadays,although many hospitals in China have met to discuss difficult cases from time to time,the establishment and application of the MDT model only exist in a few hospitals in developed areas.Consultation and treatment of MDT can improve the diagnosis efficiency and correct rate of disease,reduce the rate of misdiagnosis,improve the clinical cure rate,shorten the average length of stay and reduce the cost of hospitalization.Therefore,to carry out multidisciplinary joint consultation of surgical safety assessment for improving the level of hospital treatment and medical quality,protection of patient safety is particularly important.Objective:To explore the construction,management and operation mode of the multidisciplinary joint surgery clinic.By analyzing the multi-disciplinary consultative surgery operation safety assessment model and comparing the advantages of the multidisciplinary joint consultation with the conventional in-hospital consultation,we provide the practical application of multidisciplinary joint consultation mode ideas.Method:In this study,we randomly selected 51 patients in the MDT group and the Hospital Consultation group from Jan,2016 to Dec,2016 in a SJT hospital in Nanjing.MDT patients were enrolled in this study.Patients with Hospital Consultation conduct regular hospital congress consultation organized by medical department applying for surgical departments;analyze the implementation,precautions and problems of MDT surgical safety assessment mode.Sex,age,department of origin,reasons for consultation of operation site,number of surgical safety assessment in all departments of the hospital,preclusion of major surgery before and after consultation,definite diagnosis before and after consultation,operation time after operation,amount of intraoperative blood loss,postoperative hospital stay of patients in MDT group and Hospital Consultation group were investigated and compared.Result:(1)A total of 205 surgical safety assessments were performed in all departments,175 in all departments participated in Hospital Consultation safety assessment,and the average number of safety assessment per case(4.02±0.46)in MDT was higher than that in Hospital Consultation The number of assessments was(3.43±0.33)times,with statistically difference(P<0.05).(2)The definite diagnosis rate after the diagnosis of MDT was 92.16%higher than that of the Hospital Consultation diagnosis 76.47%,with statistically difference(P<0.05).(3)The rate of non-surgical contraindications after MDT consultation was 82.35%higher than that of no-operation contraindications rate after Hospital Consultation was 64.71%,with statistically difference(P<0.05).(4)The operation time after MDT consultation was 2.93 ± 0.68 h,shorter than Hospital Consultation,the operation time was 3.11 ± 0.96 h,with statistically difference(P<0.05).(5)The postoperative hospital stay after MDT was 14.06 ± 0.73 d,shorter than that after Hospital Consultation 19.43 ± 0.90 d,with statistically difference(P<0.05).Conclusion:The MDT surgical safety assessment model initially established by the major surgical department of a third-grade class-A hospital plays a positive role in the clear preoperative diagnosis and exclusion of contraindications to absolute surgery and in the treatment and operation of difficult cases before surgery.Preoperative MDT can optimize the preoperative diagnosis more than the routine hospital consultation,reduce the operation risk and shorten the operation time and hospitalization time.MDT surgical safety assessment model in a modern and complex medical environment as a new medical management model has a certain significance,to provide patients with personalized medical services,effectively meet the needs of clinical specialist,multidisciplinary In combination with collaboration,we will do our utmost to improve the quality of medical services and effectively reduce the incidence of medical errors,and provide a more scientific and reasonable mode of work for the diagnosis and treatment of diseases.