Improving the Effectiveness of Multidisciplinary Team Meetings for Patients with Chronic Diseases
November 2010-November 2013
Core Research Team: Caoimhe Nic a’ Bháird, Isla Wallace, Penny Xanthopoulou
Chief Investigator: Rosalind Raine
Co-applicants: Julie Barber, Jane Blazeby, Alex Clarke, Ewan Ferlie, Simon Gibbs, Michael King, Anne Lanceley, Gill Livingston, Susan Michie, Archie Prentice
Department of Health policy states that health care for cancer and chronic diseases should be delivered through multidisciplinary meetings (MDMs). However, these teams vary considerably with respect to their context (e.g. the influence of national directives), features (e.g. group processes) and the extent to which there is meaningful patient involvement. This research aims to identify factors that promote effective MDM decision making. The study involves 13 MDMs concerned with a diverse range of clinical conditions (gynaecological, skin and haematological cancers, mental health, memory clinics and heart failure). Quantitative and qualitative data are being collected by non-participant observation of MDMs, semi structured interviews with MDM members and patients, and by reviewing medical records of patients discussed. The data relate to the influence of MDM features, health care context, group decision biases and patient related factors on decisions made and their implementation. The analysis will identify the key components of effective decision making and how they relate to one another. Findings will be used to derive a series of recommendations for modifying MDMs which, the data suggest, are generalisable to different patient groups and effectively incorporate patient preferences. The modified nominal group technique will then be used to rank experts’ collective decisions about the most important and feasible recommendations that should be used to develop a modified MDM.