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Published online by Cambridge University Press: 07 July 2023
Multidisciplinary team (MDT) meetings provide a timely opportunity per week where a range of professionals involved in the service user's care come together to discuss patients and make an informed decisions as a team. With an increase in psychiatry community mental health team (CMHT) caseload (referrals in March 2021 were +5%), it is paramount we think of more efficient ways of running routine CMHT practises. Our aim was to identify the inefficiencies that surround the Aston & Nechelle's weekly MDT meetings & derive feasible modifications to make the protected team discussion time more efficient.
The PDSA (Plan-Do-Study-Act) cycle quality improvement methodology was used. A mixed qualitative & quantitative methodology was utilised. An observational study was carried out pre-intervention by two new members over 20 MDT meetings. Qualitative data were collected by identifying the key delays in MDT. Comparison of pre-intervention & post-intervention efficiency was established by quantifying the percentage of MDTs overrunning their allocated time. Satisfaction of the MDT members (n=10) with the new practise was also recorded via a questionnaire post-intervention. Our data collectors identified three main primary drivers: Systems, process & documentation.
The interventions under process included a structured agenda, table of patients for discussion & allocating designated roles within MDT. The primary driver of System, focused on creating AccurX proformas as a way to ease the use of AccurX (an integrated software program in Rio for securely contacting patients) during MDT. MDT members were trained informally to use AccurX & Smartcard (NHS spine search for patient demographic details). Finally, a standardised documentation style was trialled by creating proformas with a streamlined set of options under each agenda.
Pre-intervention showed that >90% of MDTs were starting late & >50% were running over the allocated time. Post QI implementations, 80% of MDTs ran within allocated time. 90% of people found the MDT has increased efficiency, with 30% rating it as ‘very efficient’.
The current CMHT MDT meetings have scope for more efficient practises. We should consider feasible modifications in the realm of system, process & documentation as a stepping stone to increase efficiency. This QI project suggests benefits for the wider implementation of such interventions to other CMHTs within the area.
Abstracts were reviewed by the RCPsych Academic Faculty rather than by the standard BJPsych Open peer review process and should not be quoted as peer-reviewed by BJPsych Open in any subsequent publication.
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