Multidisciplinary Bladder Exstrophy Outpatient Clinics: Patient Centred Joint Working

Abstract

PURPOSE This paper introduces the bladder exstrophy/epispadias multidisciplinary team (MDT) approach offered by the Manchester Bladder Exstrophy Service, UK. Patients with bladder exstrophy/epispadias require multidisciplinary input throughout their care. Joint working between professionals and collaborative involvement of families can facilitate client focussed service provision (Lowe et al., 2000, Journal of Interprofessional Care, 14, 269-279). The advantages and challenges of MDT working are discussed with reference to the quality of life audit data we routinely collect at bladder exstrophy/epispadias outpatient clinics. MATERIAL AND METHODS The Manchester Bladder Exstrophy Service sees approximately 88 children per year within specialist MDT outpatient clinics. The child and family meet with the whole team and are fully involved in treatment decisions. The MDT consists of Consultant Paediatric Urologists, Nurse Specialists and Clinical Psychologists who are experienced in working with children who have exstrophy/epispadias and their families. Quality of life data is collected using a psychosocial screening questionnaire specifically adapted for bladder exstrophy/epispadias. RESULTS Quality of life data indicates that children with bladder exstrophy/epispadias and their families face different challenges at different stages of development and treatment. Families report that they benefit from the MDT approach offered, and the opportunity for a “one stop shop” where they can see all the key professionals involved in the care package. CONCLUSIONS MDT working provides children and families with an integrated package of care, which can help improve communication and facilitate tailored treatment plans. Routine screening for quality of life issues is recommended as a means to improve service delivery for children with bladder exstrophy/epispadias and their families.