Improving multidisciplinary team working: Phase 2 of a quality improvement project in a tertiary care university hospital
Abstract
Introduction
The Multi-disciplinary team meeting (MDM) underpins geriatric medicine. The previously-described first phase of this project addressed variations in MDM frequency and practice across Healthcare of Older People (HCOP) wards. This second phase built on those changes with the aim of improving three key areas; process, values and skills.
efficiency / effectiveness of meetings (process)
team-working (values)
empowering of individuals (skills)
quality of the documentation (skills)
Methods
A previous survey of MDT members on 2 HCOP wards identified areas of focus and suggestions for achieving these changes. Subsequent interventions included
education sessions for resident doctors
“live” MDT document available for editing by the team before the meeting
dedicated resource folder
rotating MDT chair
support and role-modelling to encourage any MDT member to chair the meeting.
A further survey was conducted after these interventions had been embedded.
Results
The post-intervention survey of 13 MDT members found that
-54% felt satisfied with the format
-85% were satisfied with discussion content
-23% were satisfied with documentation.
An average reduction in meeting length by 12 minutes was noted. Qualitative feedback described greater efficiency of meetings. It also highlighted the need to further improve the accuracy and completeness of documentation. A rotating chair was seen as positive to the discussion and empowerment of the team.
Conclusion
These results are encouraging and give focus for future work. Next steps include
-improving documentation through rotating the role of scribe and encouraging all team members to add to the template before meetings
-regular teaching to rotating doctors on aspects or rehabilitation and MDT working
-role-modelling and support to further increase sharing of roles traditionally taken by medical staff (documentation and chairing)
-weekly MDT learning to foster a team atmosphere / empower all individuals.
Comments
I am a strong supporter of…
I am a strong supporter of MDM. It gives opportunity to provide holistic care to patients and healthcare staff gets the opportunity to learn, gain confidence and polish leadership skills effectively
Balancing efficacy with efficiency
I think this is a really interesting project that highlights a common issue- how do you balance efficacy (we know MDT working is beneficial for our patients) with efficiency (how do you prevent MDT discussion becoming wandersome and inefficient).
MDT WORKING
Hi
Often repeated study but still remains relevant in informing hospitals to bring back the MDT environment. It has started failing in lots of hospitals because of time pressure and availability of relevant people around the table. Hope in your study you had all people available for the MDT.
Well done to you all!
Really interesting work,…
Really interesting work, really like the idea of ensuring that all resident doctors are educated regarding roles of different workers.