Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Rosalind Raine, Caoimhe Nic a’ Bháird, Penny Xanthopoulou, Isla Wallace, David Ardron, Miriam Harris, Julie Barber, Archie Prentice, Simon Gibbs, Michael King, Jane M. Blazeby, Susan Michie, Anne Lanceley, Alex Clarke, Gill Livingston

Published in: BMC Psychiatry | Issue 1/2015

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
National Cancer Action Team. National Cancer Peer Review Programme Manual for Cancer Services: Haemato-oncology Cancer Measures. London: National Cancer Action Team; 2013.
2.
Department of Health. Improving Chronic Disease Management. 2004.
3.
Department of Health. Mental Health Policy Implementation Guide: Community Mental Health Teams. London: Department of Health; 2001.
4.
National Institute for Health and Clinical Excellence. Management of stable angina [NICE clinical guideline 126]. London: National Institute for Health and Clinical Excellence; 2012.
5.
Huxley P, Evans S, Baker C, White J, Philpin S, Onyett S, Gould N. Integration of social care staff within community mental health teams. Final Report. NIHR Service Delivery and Organisation Programme: Southampton; 2011.
6.
Taylor C, Atkins L, Richardson A, Tarrant R, Ramirez A. Measuring the quality of MDT working: an observational approach. BMC Cancer. 2012;12(1):1–10.CrossRef
7.
National Peer Review Programme. National Peer Review Report: Cancer Services 2012/2013: An overview of the findings from the 2012/2013 National Peer Review of Cancer Services in England. London: NHS Improving Quality; 2013.
8.
Raine R, Wallace I, Nic a Bháird C, Xanthopoulou P, Barber J, Lanceley A, Clarke C, Livingston G, Prentice A, Ardron D, et al. Improving the effectiveness of multidisciplinary team meetings for patients with chronic diseases: a prospective observational study. Health Services and Delivery Research 2014, 2(37).
9.
Raine R, Xanthopoulou P, Wallace I, Nic a’ Bháird C, Lanceley A, Clarke A, Livingston G, Prentice A, Ardron D, Harris M, et al. Determinants of treatment plan implementation in multidisciplinary team meetings for patients with chronic diseases: a mixed-methods study. BMJ Quality & Safety 2014.
10.
National Cancer Action Team. National Cancer Peer Review Programme Manual for Cancer Services: Skin Measures. London: National Cancer Action Team; 2013.
11.
National Cancer Action Team. National Cancer Peer Review Programme Manual for Cancer Services: Gynaecology Measures. London: National Cancer Action Team; 2013.
12.
Department of Health. New Horizons: A Shared Vision for Mental Health. London: Department of Health; 2009.
13.
Department of Health. Dementia Commissioning Pack: Service specification for dementia: memory service for early diagnosis and intervention. London: Department of Health; 2011.
14.
Department of Health. Closing the Gap: Priorities for Essential Change in Mental Health. London: Department of Health; 2014.
15.
Care Quality Commission. A fresh start for the regulation and inspection of mental health services. Newcastle Upon Tyne: Care Quality Commission; 2013.
16.
17.
Murphy M, Black N, Lamping D, McKee C, Sanderson C, Askham J, Marteau T. Consensus development methods, and their use in clinical guideline development. Health Technol Assess. 1998;2(3):i.PubMed
18.
Campbell S, Braspenning J, Hutchinson A, Marshall M. Research methods used in developing and applying quality indicators in primary care. BMJ. 2003;326(7393):816–9.CrossRefPubMedPubMedCentral
19.
Bisson JI, Tavakoly B, Witteveen AB, Ajdukovic D, Jehel L, Johansen VJ, Nordanger D, Garcia FO, Punamaki R-L, Schnyder U, et al. TENTS guidelines: development of post-disaster psychosocial care guidelines through a Delphi process. Br J Psychiatry. 2010;196(1):69–74.CrossRefPubMed
20.
Crawford MJ, Price K, Rutter D, Moran P, Tyrer P, Bateman A, Fonagy P, Gibson S, Weaver T. Dedicated community-based services for adults with personality disorder: Delphi study. Br J Psychiatry. 2008;193(4):342–3.CrossRefPubMed
21.
Hutchings A, Raine R. A systematic review of factors affecting the judgments produced by formal consensus development methods in health care. J Health Serv Res Policy. 2006;11(3):172–179H.CrossRefPubMed
22.
Black N, Murphy M, Lamping D, McKee M, Sanderson C, Askham J, Marteau T. Consensus development methods: a review of best practice in creating clinical guidelines. J Health Serv Res Policy. 1999;4(4):236–48.PubMed
23.
Fitch K, Bernstein SJ, Aguilar MD, Burnand B, LaCalle JR. The RAND/UCLA appropriateness method user’s manual. Santa Monica: RAND Corporation; 2001.
24.
Department of Health. Choosing Health: supporting the physical needs of people with severe mental illness - commissioning framework. London: Department of Health; 2006.
25.
Royal College of Psychiatrists. Memory Services National Accreditation Programme: standards for memory services. London: Royal College of Psychiatrists; 2012.
26.
Department of Health. Living well with dementia: a national dementia strategy. London: Department of Health; 2009.
27.
National Collaborating Centre for Mental Health. A NICE-SCIE Guideline on supporting people with dementia and their carers in health and social care. Guideline no 42. London: National Collaborating Centre for Mental Health; 2007.
28.
National Institute for Health and Clinical Excellence. Dementia: Supporting people with dementia and their carers in health and social care. NICE Clinical Guideline 42. London: National Institute for Health and Clinical Excellence; 2006.
29.
The Royal College of Radiologists. Cancer Multidisciplinary Team Meetings - Standards for Clinical Radiologists. London: Royal College of Radiologists; 2005.
30.
National Institute for Health and Clinical Excellence. Guidance on Cancer Services: Improving Outcomes in Haematological Cancers: The Manual. London: National Institute for Clinical Excellence; 2003.
31.
Academy of Medical Royal Colleges. Intercollegiate Cancer Committee: Educational Initiatives to Improve the Effectiveness of Cancer Multidisciplinary Teams. London: Academy of Medical Royal Colleges; 2009.
32.
National Cancer Action Team. The Characteristics of an Effective Multidisciplinary Team. London: NHS National Cancer Action Team; 2010.
33.
NHS Improvement. A guide for review and improvement of hospital based heart failure services. NHS Improvement: Leicester; 2011.
34.
National Institute for Health and Clinical Excellence. Chronic heart failure: Management of chronic heart failure in adults in primary and secondary care. NICE Clinical Guideline no 108, vol. GC108. London: National Institute for Health and Clinical Excellence; 2010.
35.
National Institute for Health and Clinical Excellence. Services for people with chronic heart failure. London: National Institute for Health and Clinical Excellence; 2011.
36.
37.
Hutchings A, Raine R, Sanderson C, Black N. An experimental study of determinants of the extent of disagreement within clinical guideline development groups. Qual Saf Health Care. 2005;14(4):240–5.CrossRefPubMedPubMedCentral
38.
Field KM, Rosenthal MA, Dimou J, Fleet M, Gibbs P, Drummond K. Communication in and clinician satisfaction with multidisciplinary team meetings in neuro-oncology. J Clin Neurosci. 2010;17(9):1130–5.CrossRefPubMed
39.
Fay D, Borrill C, Amir Z, Haward R, West MA. Getting the most out of multidisciplinary teams: A multi-sample study of team innovation in health care. J Occup Organ Psychol. 2006;79(4):553–67.CrossRef
40.
West M, Alimo-Metcalfe B, Dawson J, El Ansari W, Glasby J, Hardy G, Hartley G, Lyubovnikova J, Middleton H, Naylor P. Effectiveness of Multi-Professional Team Working (MPTW) in Mental Health Care. NIHR Service Delivery and Organisation Programme: Final Report; 2011.
41.
Blazeby J, Wilson L, Metcalfe C, Nicklin J, English R, Donovan J. Analysis of clinical decision-making in multi-disciplinary cancer teams. Ann Oncol. 2006;17(3):457–60.CrossRefPubMed
42.
English R, Metcalfe C, Day J, Rayter Z, Blazeby J. A Prospective Analysis of Implementation of Multi-Disciplinary Team Decisions in Breast Cancer. Breast J. 2012;18(5):459–63.CrossRefPubMed
43.
Kidger J, Murdoch J, Donovan J, Blazeby J. Clinical decision-making in a multidisciplinary gynaecological cancer team: a qualitative study. BJOG. 2009;116(4):511–7.CrossRefPubMed
44.
Care Quality Commission. National Summary of the Results for the 2014 Community Mental Health Survey. Newcastle upon Tyne: Care Quality Commission; 2014.
45.
Raine R, Sanderson C, Hutchings A, Carter S, Larkin K, Black N. An experimental study of determinants of group judgments in clinical guideline development. Lancet. 2004;364(9432):429–37.CrossRefPubMed
46.
Loblaw DA, Prestrud AA, Somerfield MR, Oliver TK, Brouwers MC, Nam RK, Lyman GH, Basch E. American Society of Clinical Oncology Clinical Practice Guidelines: Formal Systematic Review–Based Consensus Methodology. J Clin Oncol. 2012;30(25):3136–40.CrossRefPubMed
47.
Metadata
Title
Use of a formal consensus development technique to produce recommendations for improving the effectiveness of adult mental health multidisciplinary team meetings
Authors
Rosalind Raine
Caoimhe Nic a’ Bháird
Penny Xanthopoulou
Isla Wallace
David Ardron
Miriam Harris
Julie Barber
Archie Prentice
Simon Gibbs
Michael King
Jane M. Blazeby
Susan Michie
Anne Lanceley
Alex Clarke
Gill Livingston
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-015-0534-6

Other articles of this Issue 1/2015

BMC Psychiatry 1/2015 Go to the issue

Research article

Can mental health interventions change social networks? A systematic review

Research article

Conceptualizing and contextualizing functioning in people with severe mental disorders in rural Ethiopia: a qualitative study

Research article

Asymmetric dimethylarginine in somatically healthy schizophrenia patients treated with atypical antipsychotics: a case–control study

Research article

Predicting posttraumatic stress disorder in children and parents following accidental child injury: evaluation of the Screening Tool for Early Predictors of Posttraumatic Stress Disorder (STEPP)

Research article

Attachment and coping in psychosis in relation to spiritual figures

Research article

The efficacy and safety of once-daily quetiapine extended release in patients with schizophrenia switched from other antipsychotics: an open-label study in Chinese population