Heart Team Guidance
Structure and functioning of a Multidisciplinary “Heart Team” in patients with coronary artery disease
Rationale and Recommendations from a Joint BCS/BCIS/SCTS Working Group
1.1 International Guidelines from both the Cardiology and Cardiac Surgery Societies have recommended the utilisation of a Multidisciplinary Team (MDT) approach to assist in guiding the management of patients with coronary artery disease (CAD). Whilst such a process is well recognised as beneficial in other areas of medicine, and also incorporated into some elements of current cardiological practice, its routine use in the context of CAD is less established. The functioning of such a “Heart Team” varies across the UK as does its composition, frequency and the type of cases discussed.
1.2 It is the intention of this document to provide guidance as to the essential components of a Heart Team in terms of how it should be structured and how it should function. This includes its attendance, scheduling and frequency as well as the type of cases to be discussed and the minimum data to be presented. Importantly, it also addresses the required managerial, administrative and technological support, systems of documentation, feedback and audit, and the degree and timing of patient/carer involvement.
1.3 It is acknowledged that working environments will differ; surgical as opposed to non-surgical cardiology centres is one such example. It is envisaged therefore that the fundamental components of this document will form a foundation upon which MDT policy for individual units may then be developed. Similarly it is anticipated that it can be used in order to identify any shortfalls in current practices, prompt those initiatives that will deliver improvement and assist to secure the necessary resources that will then allow a robust MDT process to be established.