Development of a novel multidisciplinary team meeting model: Providing excellence in patient care
D van Dellen, H Khambalia, G Giuffrida ,T Augustine, WP Stephens

Background:
Transplant is at the forefront of providing team-based care, replacing the traditional model of an individual clinician working in isolation. However, in contentious decision-making, personal interactions may impact on clarity of process and outcome. There is currently no competency-based training preceding a consultant chairing a multidisciplinary team meeting (MDT). Optimal outcomes may be protected by development of a model of an independent external chair, ensuring patient centred decisions. We present our experience in this development,

Methods
A recently retired diabetologist has chaired the departmental transplant MDT for 4 years. This has incorporated clinical and radiology meetings, as well as departmental morbidity and mortality meetings. The methods utilised included to:
•	Encourage a robust and frank exchange of views: ensure patient focused care. 
•	Ensure that a resolved position will always be reached.
•	Protect the meeting from immediate external distractions and influences.
•	Provide training opportunities.
This was done pro bono, impartially and with the express aim of not providing a clinical opinion.

Results:
The independent chair has:
•	Provided a transformative effect on morale and behaviours as well as afforded a role model for trainees
•	Ensured a convivial atmosphere for a robust exchange of differing views to ensure optimal decision making.
•	Become a valued neutral ‘sounding board’ for other issues within the clinical team.

Conclusions:
Transplantation is almost unique in that clinical practice occurs within the context of an informed patient population where major surgery can be carried out by a surgeon who has not built the initial patient rapport that pre-operative work-up provides. This is in the context of the significant pressures of published outcome data and stresses any team structure. A functional collaborative MDT aiming for optimal patient opportunities and outcomes is enhanced by independent decision-making.

[P036] Development of a novel multidisciplinary team meeting model: Providing excellence in patient care.