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BMC Psychiatry. 2015 Jul 3;15:143. doi: 10.1186/s12888-015-0534-6.

Use of a formal consensus development technique to produce recommendations for improving the effectiveness of adult mental health multidisciplinary team meetings.

Author information

1
Department of Applied Health Research, University College London, London, WC1E 7HB, UK. r.raine@ucl.ac.uk.
2
Department of Applied Health Research, University College London, London, WC1E 7HB, UK. c.bhaird@ucl.ac.uk.
3
Department of Applied Health Research, University College London, London, WC1E 7HB, UK. P.D.Xanthopoulou@exeter.ac.uk.
4
Department of Applied Health Research, University College London, London, WC1E 7HB, UK. i.wallace@ucl.ac.uk.
5
Patient and Public Involvement Representative, North Trent Cancer Research Network, Consumer Research Panel, ICOSS, The University of Sheffield, Western Bank, Sheffield, S10 2TN, UK. daveardron@aol.com.
6
Patient and Public Involvement Representative, London, UK. miriam@harrises.eu.
7
Department of Statistical Science, University College London, Gower Street, London, WC1E 6BT, UK. j.barber@ucl.ac.uk.
8
Royal College of Pathologists, 2 Carlton House Terrace, London, SW1Y 5AF, UK. archie.prentice@rcpath.org.
9
National Heart and Lung Institute, Imperial College London, Du Cane Road, London, W12 0HS, UK. s.gibbs@imperial.ac.uk.
10
Department of Cardiology, Hammersmith Hospital, Du Cane Road, London, W12 0HS, UK. s.gibbs@imperial.ac.uk.
11
Division of Psychiatry, University College London, Charles Bell House, 67-73 Riding House St, London, W1W 7EH, UK. m.king@medsch.ucl.ac.uk.
12
School of Social and Community Medicine, University of Bristol, Bristol, BS8 2PS, UK. j.m.blazeby@bristol.ac.uk.
13
UCL Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK. s.michie@ucl.ac.uk.
14
Department of Women's Cancer, UCL Elizabeth Garrett Anderson Institute for Women's Health, University College London, Medical School Building, 74 Huntley Street, London, WC1E 6AU, UK. a.lanceley@ucl.ac.uk.
15
Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, Pond Street, Hampstead, London, NW3 2QG, UK. alexmacleodclarke@gmail.com.
16
Mental Health of Older People, Division of Psychiatry, University College London, Charles Bell House, 67-73 Riding House Street, London, W1W 7EH, UK. g.livingston@ucl.ac.uk.

Abstract

BACKGROUND:

Multidisciplinary team (MDT) meetings are the core mechanism for delivering mental health care but it is unclear which models improve care quality. The aim of the study was to agree recommendations for improving the effectiveness of adult mental health MDT meetings, based on national guidance, research evidence and experiential insights from mental health and other medical specialties.

METHODS:

We established an expert panel of 16 health care professionals, policy-makers and patient representatives. Five panellists had experience in a range of adult mental health services, five in heart failure services and six in cancer services. Panellists privately rated 68 potential recommendations on a scale of one to nine, and re-rated them after panel discussion using the RAND/UCLA Appropriateness Method to determine consensus.

RESULTS:

We obtained agreement (median ≥ 7) and low variation in extent of agreement (Mean Absolute Deviation from Median of ≤1.11) for 21 recommendations. These included the explicit agreement and auditing of MDT meeting objectives, and the documentation and monitoring of treatment plan implementation.

CONCLUSIONS:

Formal consensus development methods that involved learning across specialities led to feasible recommendations for improved MDT meeting effectiveness in a wide range of settings. Our findings may be used by adult mental health teams to reflect on their practice and facilitate improvement. In some other contexts, the recommendations will require modification. For example, in Child and Adolescent Mental Health Services, context-specific issues such as the role of carers should be taken into account. A limitation of the comparative approach adopted was that only five members of the panel of 16 experts were mental health specialists.

PMID:
26138754
PMCID:
PMC4489364
DOI:
10.1186/s12888-015-0534-6
[Indexed for MEDLINE]
Free PMC Article

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