In geriatric medicine department of a large tertiary care university hospital, it was observed that multidisciplinary team (MDT) working was not standardised, morning huddles were inefficient, there was a lack of inclusion of all members in MDT meetings and the meetings were too medical focused. The aim of this project was to address these concerns through a multipronged approach.
An initial survey was carried out with 34 participants from all disciplines of MDT. Areas needing improvement were identified from the survey and through discussions among doctors, nurses and therapists. A pilot of changes was introduced in the largest ward of the department. A post change survey was carried out, demonstrating improvement across multiple domains.
Changes implemented:
- Structured daily morning board round with all MDT disciplines using a new pro forma
- MDT meetings led by flow-coordinator via a structured format making them more holistic, person-centred and inclusive
- Publishing of handbook to improve understanding and purpose of MDT’s and terminologies used in meetings.
Post change survey showed:
- 66% said meetings now more structured; easier to share their views
- 75% felt more valued
- 76% thought meetings now were more person-centred
- Improved attendance & efficiency of morning huddle (mean time reduced to 10 from 30 minutes).
These findings were presented and shared in departmental monthly meeting.
The true essence of MDT working lies in all professions coming together to achieve patient-centred care. This can only be achieved if all professions understand and respect each other’s role and responsibilities. Through best practices, we can achieve more holistic care and prevent harm. It results in resources being used more efficiently through reduced duplication, greater productivity and preventative care approaches. Through a series of changes we demonstrated these in one ward and plan to replicate and implement these changes across the whole department.