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Improving the Effectiveness of Multidisciplinary Team Meetings for Patients with Chronic Diseases

November 2010-November 2013


Background

  • Multidisciplinary team (MDT) meetings are widely established in the NHS and have been endorsed by the Department of Health as the core model for managing chronic diseases.
  • It is believed that MDT meetings ensure higher quality decision making and improved outcomes. However, the evidence underpinning their development is not strong and the degree to which they have been absorbed into clinical practice varies across conditions and settings.
  • We conducted a large mixed-methods observational study of multidisciplinary teams in chronic diseases to investigate current MDT meeting practice and examine the determinants of effective decision making.
  • Drawing on this data, we applied consensus methods to develop recommendations to improve MDT meeting decision making and effectiveness.


Aim

To develop a set of feasible recommendations for improving multidisciplinary team meetings for patients with chronic diseases.


Objectives

  • To undertake an observational study of chronic disease MDT meetings to identify factors which influence their effectiveness in terms of decision implementation.
  • To examine associations between team characteristics, discussion features, patient characteristics and decision implementation.
  • To explore methods for the inclusion of patient preferences in MDT meeting discussions.
  • To derive a set of feasible modifications to MDT meetings using a structured formal consensus method.


Participating Teams

mdts




Methods

methods
     
     

Findings & Dissemination

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The poster below provides an outline of the project.

MDT study



Project Team & Contact Details

Chief Investigator:

Professor Rosalind Raine


Research Associates:

Penny Xanthopoulou

Isla Wallace

Caoimhe Nic a' Bháird


Co-applicants:

  • Dr Julie Barber, Department of Statistical Science, University College London
  • Professor Jane M Blazeby, School of Social and Community Medicine, Bristol University
  • Dr Alex Clarke, Department of Plastic and Reconstructive Surgery, The Royal Free Hospital
  • Professor Ewan Ferlie, Department of Management, King's College London
  • Dr Simon Gibbs, National Heart and Lung Institute, Imperial College London
  • Professor Michael King, Mental Health Sciences Unit, University College London
  • Dr Anne Lanceley, Elizabeth Garrett Anderson Institute for Women’s Health, University College London
  • Professor Gill Livingston, Mental Health Sciences Unit, University College London
  • Professor Susan Michie, Department of Clinical, Educational and Health Psychology, University College London
  • Dr Archie Prentice, Royal College of Pathologists

Patient and Public Involvement Representatives: 

  • Dave Ardron, Patient and Public Involvement Representative, Chair, North Trent Cancer Research Network Consumer Research Panel, ICOSS, Sheffield University
  • Miriam Harris, Patient and Public Involvement Representative

Publications

Raine R, Xanthopoulou P, Wallace I, Nic a’ Bháird C, Lanceley A, Clarke A, Livingston G, Prentice A, Ardron D, Harris M, King M, Michie S, Blazeby J M, Austin-Parsons N, Gibbs S, Barber J (2014). Determinants of treatment plan implementation in multidisciplinary team meetings for patients with chronic diseases: a mixed-methods study. BMJ Quality & Safety doi:10.1136/bmjqs-2014-002818 http://qualitysafety.bmj.com/cgi/rapidpdf/bmjqs-2014-002818?ijkey=yjzuB1WbUUdQvCk&keytype=ref

Raine R, Wallace I, Nic a Bháird C, Xanthopoulou P, Barber J, Lanceley A, Clarke A, Livingston G, Prentice A, Ardron D, Harris M, Michie S, Blazeby JM, Gibbs S, Ferlie E. Improving the effectiveness of multidisciplinary team meetings for patients with chronic diseases: a prospective observational study. Health Services and Delivery Research (in press)

Funding

This study is funded by the NIHR Health Services and Delivery Research Programme

nihr