A Quality Improvement Initiative: Developing a Multi-Disciplinary Team for Infective Endocarditis

Mo Med. 2019 Jul-Aug;116(4):291-296.

Abstract

Background: As guidelines do not describe how to develop a multi-disciplinary team(MDT), we provide a model using quality improvement tools to design a MDT for infective endocarditis (IE).

Methods: Primary service, specialty teams and whether they had surgery or not (indications, reasons, outcomes and complications) were recorded for IE patients for January-December 2016. Criteria: age >18years and definite IE per modified Duke criteria.

Results: Of all cases, 29/82 met criteria. Primary service: internal medicine 18(62.1%), medical intensive care and cardiology 4(13.8%) each, family medicine 2(7.9%) and pediatrics 1(3.4%). Surgery was indicated in 21(72.4%), 9 (42.9%) underwent surgery, 12 (57.1%) did not [6/9(66.67%) left side IE died, all right side IE (3,25%) survived] and 2 (22.2%) had missed opportunities and this was chosen as the leverage point. MDT was developed to reduce the number of left sided IE patients not undergoing surgery despite indications.

Conclusions: Quality improvement and team development tools help in developing MDT for IE.

MeSH terms

  • Endocarditis / diagnosis
  • Endocarditis / surgery
  • Endocarditis / therapy*
  • Humans
  • Missouri
  • Patient Care Team / organization & administration*
  • Program Development
  • Quality Improvement / organization & administration*