Background Multidisciplinary (MDT) meetings are particularly important in palliative care (O’Connor, Fisher, Guilfoyle. Int J Palliative Nurs. 2006;12(3): 132–7). These meetings should help to deliver personalised care to the patient (NHS England. Personalised care.[internet]) through psychologically safe team discussion (Wisdom, Wei. NEJM Catalyst. 2017;3,1). There was dissatisfaction with the MDT meeting in our hospice thus a working group was established to rejuvenate the meetings.
Aims To evaluate the problems with existing MDT meetings, review the literature, gather ideas from other hospices then re-invent the meeting based on the findings.
Methods May – Sept. 2022. Working group formed to address problems with the MDT meeting, research other practices and develop a new format. Oct. 2022. New ideas proposed. Nov. 2022. New format launched. Jan. – Feb. 2023. Feedback collected (by way of a questionnaire) and meeting adjusted.
Results Problems with the MDT meetings included (but were not limited to): a feeling of hierarchy, few team members contributing to discussion, insufficient emphasis on community or hospital patients, presenting patients in a medicalised way, and a lack of team cohesiveness exacerbated by virtual meetings. Particular inspiration for future direction was taken from Forest Holme Hospice (Dorset) which developed ‘Results Through Relationships’ (Dorman. Results through relationships – part 1. Next Stage Radicals [internet] 2020 Nov 19).
The new in-person meeting was relaunched under the name: ‘interprofessional meeting’ which reflects the aim to share decision making amongst the team (Kesonen, Salminen, Kero, et al. Omega. 2022 Apr 19:302228221085468). Just three patients are discussed in depth each week with discussion centred around ‘what matters most’ to the patient. There is an emphasis on team learning, holistic care for the patient and family and relevant information is disseminated.
Conclusions Feedback from the team shows that team members prefer to meet in person rather than virtually, more team members contribute to discussions and there is shared learning. The majority feel that we are now prioritising ‘what matters most’.
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