Improving the documentation of the weekly multidisciplinary team (MDT) meeting on a care of the elderly ward

I recognised the need for improvement of the weekly MDT discussions on a care of the elderly ward. These meetings focused on ensuring each patient had a comprehensive geriatric assessment completed, and had input from a medical, nursing, physiotherapist(PT), occupational therapist(OT), social worker(SW) and pharmacist perspective.  

Measures for this project included ensuring a standardised proforma was used to document the MDT discussions. This included ensuring that staff present was recorded, clinical frailty score(CFS), functional status and escalation status for each patient was documented. Updates from a medical, nursing, PT, OT, SW and pharmacy teams were recorded. 

Baseline data revealed that 50% of patients had an MDT discussion documented; of these patients none had CFS score documented, functional status, nursing, OT and pharmacist update recorded, None had family updated or outstanding tasks documented. 44% had escalation status documented, 89% had medical update, 11% had PT and 56% had SW update. 

Key stakeholders of the project were contacted which allowed a standardised proforma to be created and used at the meetings. 

PDSA cycle 1 was education of staff, PDSA cycle 2 took place following staff feedback, PDSA cycle 3 involved a change to the proforma, PDSA 4 involved consulting the charge nurse leading MDTs, PDSA cycle 5 involved further update of proforma. Following this PDSA cycle 5, all had staff present documented, CFS score, escalation status, medical update and current functional status and nursing update recorded. PT update, OT and SW update improved to 91%, 96% and 96% respectively. 91% of patients had pharmacy update recorded and family update improved to 83%. 96% patients had outstanding task box complete. Data was collected a few weeks later to ensure sustainability

Success of project involved regular involvement of stakeholders throughout project, with aim to roll out template to other wards across hospital site.