General Practice Based Multidisciplinary Care Teams in Australia: Still some unanswered questions. A discussion paper from the Australian General Practice Network

2007 ◽  
Vol 13 (2) ◽  
pp. 10 ◽  
Author(s):  
Rachel Yates ◽  
Leanne Wells ◽  
Kate Carnell
Keyword(s):  
General Practice ◽  
Multidisciplinary Team ◽  
Policy Development ◽  
Grey Literature ◽  
Multidisciplinary Care ◽  
Multidisciplinary Teams ◽  
Discussion Paper ◽  
Team Working ◽  
Australian General Practice ◽  
Practice Network

Evidence indicates that general practice-based multidisciplinary teams can offer a means of addressing some of the key issues currently facing Western health systems, especially workforce and chronic disease management. Elements of team-working have been addressed in research and policy initiatives both overseas and in Australia, yet some important aspects of primary health care multidisciplinary team-working still remain unclear in the Australian context. This discussion paper has been developed by the Australian General Practice Network (AGPN) to raise awareness of and promote thought on four questions relating to multidisciplinary team-working that AGPN considers important but that, as yet, have not been fully addressed. (Except where indicated, it is not a position statement about AGPN's views on this matter.) Questions considered are: Who is in the team? What makes a successful team? How should teams be funded in Australia? Who coordinates the team? Each question broadly considers what is already known about the area through purposeful literature reviews of the published and grey literature, current policy impacting on the area, and suggested areas for policy development in the context of Australian general practice and primary care.

scholarly journals Investigating the system effect of reporting multidisciplinary care measures for cancer services in New South Wales, Australia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kahren M. White ◽  
Ru K. Kwedza ◽  
Holly Seale ◽  
Reema Harrison
Keyword(s):  
Quality Improvement ◽  
Multidisciplinary Team ◽  
Multidisciplinary Care ◽  
System Level ◽  
Multidisciplinary Teams ◽  
Local Health ◽  
Unique Contribution ◽  
Framework Analysis ◽  
Electronic Documentation ◽  
System Effect

Abstract Background Multidisciplinary cancer care to facilitate the provision of patient centred and evidence-based care is considered best practice internationally. In 2016 multidisciplinary care measures were developed for all local health districts across NSW. The aim of this study was to identify system-level changes and quality improvement activities across the NSW cancer system linked to reporting on these measures. Methods Focus group discussions were used to generate a synergy of ideas from key stakeholders. An exploratory descriptive approach was used within the ontological position of Framework Analysis, the analysis method chosen for this research study, sitting most closely within pragmatism. The use of Framework Analysis in the analytic strategy is because it is well-suited to addressing policy issues and maintaining specific focus within a wider dataset. Results Two focus groups were held with a total of 18 purposively selected participants. Four primary themes emerged: value of electronic documentation; role clarity; relationships; and future development of measures. Key findings included that the reporting of performance measures has expedited the development of electronic documentation and data extraction from the multidisciplinary team meeting (MDT), identified barriers and facilitators to MDT data collection and supported MDT improvement activities across NSW. Conclusions The findings of this study have highlighted that MDTs and their meetings across NSW are harnessing technological advancements to support and further develop their MDTs, as well as the challenges of implementing new processes within the MDTM. This study adds a unique contribution to knowledge of how the reporting of measures can assist in understanding variation in the development and implementation of multidisciplinary teams, as well as highlighting future programs of work to decrease variation in multidisciplinary team meetings and quality improvement activities.

scholarly journals Patients’ and carers’ perspectives of palliative care in general practice: A systematic review with narrative synthesis

2018 ◽  
Vol 32 (4) ◽  
pp. 838-850 ◽  
Author(s):  
Emilie Green ◽  
Selena Knight ◽  
Merryn Gott ◽  
Stephen Barclay ◽  
Patrick White
Keyword(s):  
Palliative Care ◽  
General Practice ◽  
General Practitioner ◽  
General Practitioners ◽  
Policy Development ◽  
Survey Methods ◽  
Grey Literature ◽  
Reference List ◽  
Narrative Synthesis

Background: General practitioners have overall responsibility for community care, including towards end of life. Current policy places generalists at the centre of palliative care provision. However, little is known about how patients and carers understand the general practitioner’s role. Aims: To explore patient and carer perspectives of (1) the role of the general practitioner in providing palliative care to adult patients and (2) the facilitators and barriers to the general practitioner’s capacity to fulfil this perceived role. Design: Systematic literature review and narrative synthesis. Data sources: Seven electronic databases (MEDLINE, Embase, PsycINFO, BNI, CINAHL, Cochrane and HMIC) were searched from inception to May 2017. Two reviewers independently screened papers at title, abstract and full-text stages. Grey literature, guideline, hand searches of five journals and reference list/citation searches of included papers were undertaken. Data were extracted, tabulated and synthesised using narrative, thematic analysis. Results: A total of 25 studies were included: 14 employed qualitative methods, 8 quantitative survey methods and 3 mixed-methods. Five key themes were identified: continuity of care, communication between primary and secondary care, contact and accessibility, communication between general practitioner and patient, and knowledge and competence. Conclusion: Although the terminology and context of general practice vary internationally, themes relating to the perceived role of general practitioners were consistent. General practitioners are considered well placed to provide palliative care due to their breadth of clinical responsibility, ongoing relationships with patients and families, and duty to visit patients at home and coordinate healthcare resources. These factors, valued by service users, should influence future practice and policy development.

scholarly journals Videoconferencing for multidisciplinary team meetings in the coronavirus disease era – human factors awareness and recognition

2020 ◽  
pp. 1-2
Author(s):  
C Kerawala ◽  
F Riva ◽  
V Paleri
Keyword(s):  
Human Factors ◽  
Multidisciplinary Care ◽  
Multidisciplinary Teams ◽  
Technology Support ◽  
Team Meetings ◽  
Team Working ◽  
Rapid Dissemination ◽  
Care Demands ◽  
E Mail

Abstract Background The coronavirus disease 2019 pandemic has led to the birth of videoconference multidisciplinary teams, which are now commonplace. This remote way of deciding care demands a new set of rules to ensure the quality of the complex decisions that are made for the patient group needing multidisciplinary care. Videoconference multidisciplinary teams bring with them novel forms of distraction that are under-appreciated and can impair decision-making. Method A practical checklist was generated as applied to videoconference multidisciplinary teams using the principles of human factors awareness and recognition. Results Some of the strategies that should be adopted to minimise errors arising from human factors are: information technology support, a suitable environment to dial in, a global checklist employed prior to the videoconference, visible participants, avoiding distractions from other sources (e.g. e-mail, mobile phone), a videoconference sign-out and rapid dissemination of the outcomes sheet. Conclusion This article presents a framework that uses human factors principles applied in this setting, which will contribute to enhanced patient safety, team working and a reduction in medical errors.

Multidisciplinary Team Care Arrangements in the management of patients with chronic disease in Australian general practice

2011 ◽  
Vol 194 (5) ◽  
pp. 236-239 ◽  
Author(s):  
Mark F Harris ◽  
Upali W Jayasinghe ◽  
Jane R Taggart ◽  
Bettina Christl ◽  
Judith G Proudfoot ◽  
...  
Keyword(s):  
General Practice ◽  
Chronic Disease ◽  
Multidisciplinary Team ◽  
Team Care ◽  
Australian General Practice

scholarly journals 17 Interprofessional mentoring: the key towards a better multidisciplinary team working model?

2020 ◽  
Author(s):  
Baguiasri Mandane ◽  
Shivanee Nakum ◽  
Jagraj Thandi ◽  
Jekaterina Jasina
Keyword(s):  
Multidisciplinary Team ◽  
Working Model ◽  
Team Working

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

#69: Improving Communication About the Care and Prevention of Infections in a Pediatric Oncology Unit by Using Patient Daily Goals in Multidisciplinary Rounds

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S22-S22
Author(s):  
Escobedo-Melendez Griselda ◽  
Martinez-Albarran Manuel ◽  
Magaña-Saldivar Isadora ◽  
Jimenez Norma ◽  
Gomez-Huerta Elizabeth ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Pediatric Oncology ◽  
Multidisciplinary Team ◽  
Statistical Significance ◽  
Healthcare Providers ◽  
Multidisciplinary Teams ◽  
Use Of Resources ◽  
Multidisciplinary Rounds ◽  
Prevention Of Infections ◽  
Oncology Unit

Abstract Background In children with cancer infections are the most frequent complication, with fatal outcomes if not addressed promptly. Therefore, care and prevention of infections in these patients require multidisciplinary interventions, with effective communication among healthcare providers to reduce the morbidity, length of stay, and the inappropriate use of resources. We used the Institute of Healthcare Improvement (IHI) model for improving the communication among healthcare providers by using patient daily goals after the oncology pediatric unit multidisciplinary rounds. Methods A multidisciplinary team was identified in the pediatric oncology unit. The team received weekly coaching on the IHI methodology. The methodology used included the creation of a block diagram to understand the baseline processes and a key driver diagram. Then, after a literature review, a data collection plan and measures were identified. The team identified different ideas for changes and prioritized them using an impact-effort matrix. Finally, several rounds of Plan-Do-Study-Act (PDSA) cycles reached the desired changes that organized the patient daily goals for sharing in the form of a worksheet. This worksheet was shared with nurses and pharmacist staff, a chat group was created, and the routine use of the daily goals for patient management was taught and incorporated into the rest of the care team staff. The percentage of excellent communication among all multidisciplinary teams and outcomes (length of stay, intensive care unit admission, and mortality) were recorded at baseline and endline. We determined the statistical significance of the baseline vs. endline difference by using χ 2 and t-tests. Results A total of 105 patients with suspected infections were included over a 6-month period (June through November 2019). We found a significant increase per month in the percent of agreement in excellent communication in the patient daily goals between infectious diseases specialist faculty and fellows, nurses, pharmacist, and pediatric oncology faculty and fellows (33.3% vs. 91.3%) (P = 0.004). Length of stay decreased monthly after our interventions (baseline: mean 14.7 days [SD 12.4] vs. after intervention: mean 6.7 days [SD 2.7]) (P = 0.014). There were only one ICU admission and no deaths during the implementation period. Conclusions Our approach using patient daily goals improved communication among a multidisciplinary team, leading to decreased length of stay and supporting adequate outcomes.

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