Abstract
Introduction: Severe lung diseases (COPD, asthma, etc, …) pose a significant health burden worldwide, including Slovenia (population two million). Although the mortality due to respiratory diseases in Slovenia is decreasing, in the period of 2000 to 2019 it decreased from 74/100.000 inhabitants to 52/100.000 inhabitants, it still has a substantial impact on the healthcare system. To address the challenges associated with severe lung diseases, a multidisciplinary team (MDT) approach has been implemented at the first examination of patients with severe lung disease, where treatment decisions are coordinated and integrated.
Methodology: The MDT comprises various healthcare professionals who collaborate to provide comprehensive and integrated care for patients with severe lung disease. It includes a specialist doctor (pulmonologist), respiratory physiotherapist, clinical pharmacist, dietitian, clinical psychologist, graduate nurse, and radiologist. Each team member plays a crucial role in the patient's treatment journey. The pulmonologist conducts an examination of the patient, reviews relevant documentation, and orders necessary laboratory and diagnostic tests. Pulmonologist also prepares the patient's discharge certificate, outlining the treatment plan. The respiratory physiotherapist focuses on breathing exercise techniques and airway cleaning techniques, with the aim to improve lung function and enhance the patient's respiratory well-being. The clinical pharmacist provides insights into medication use and assists in solving any problems related to medication. The dietician offers advice on nutrition and develops individualized diet plans tailored to the patient's specific needs, thus contributing to overall health, and potentially improving lung function. The clinical psychologist conducts a clinical psychological interview, placing emphasis on the patient's experience and coping mechanisms related to lung disease. The graduate nurse performs various tasks, including gathering nursing history, providing health education, conducting blood and other material sampling, monitoring vital signs, performing EKGs, administering allergy skin tests, registering patients in the severe asthma register, ensuring proper inhaler technique, and facilitating asthma or COPD schools. The radiologist participates in consultations to define the treatment plan for patients with severe lung disease and has a prominent role in interpreting radiological images adding to accurate diagnosis and treatment decisions.
Integrated Approach: The MDT works collaboratively at the location where the patient is located, ensuring seamless coordination and integration of care. This approach enables efficient communication and streamlines decision-making. It ensures patient-centeredness across primary, secondary, and tertiary care. The services of all participants in the first examination of a patient with a severe lung disease are financially covered by a single payment of 1,308 Euros.
Consultation and Treatment Plan: Following the completion of treatment by all team members, a consultation is held, involving the entire MDT. Each team member presents their findings and prepares their respective reports. Pulmonologist then prepares the patient's discharge form from the MDT examination, outlining the methods of further treatment. In complex cases, an interventional pulmonologist may also participate in the consultation.
Conclusion: The multidisciplinary approach with the integrated payment to patients with severe lung disease at the first examination allows for coordinated and integrated decision-making regarding treatment. The collaboration among various healthcare professionals ensures comprehensive care and improves patient outcomes.