Evidence map›Paper›PMID 35676685›Full record

ArticleBMC health services research2022

Observations of community-based multidisciplinary team meetings in health and social care for older people with long term conditions in England.

Nick Douglas, Nicholas Mays, Mustafa Al-Haboubi, Tommaso Manacorda, Lavanya Thana, Gerald Wistow, Mary Alison Durand

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Nick DouglasPolicy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK. nick.douglas@sussex.ac.uk.
Nicholas MaysPolicy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Mustafa Al-HaboubiPolicy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Tommaso ManacordaPolicy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Lavanya ThanaPolicy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Gerald WistowPolicy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Mary Alison DurandPolicy Innovation and Evaluation Research Unit (PIRU), Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCommunity-based multi-disciplinary teams (MDTs) are the most common means to encourage health and social care service integration in England yet are rarely studied or directly observed. This paper reports on two rounds of non-participant observations of community-based multi-disciplinary team (MDT) meetings in two localities, as part of an evaluation of the Integrated Care and Support Pioneers Programme. We sought to understand how MDT meetings coordinate care and identify their 'added value' over bilateral discussions.

methodsTwo rounds of structured non-participant observations of 11 MDTs (28 meetings) in an inner city and mixed urban-rural area in England (June 2019-February 2020), using a group analysis approach.

resultsDespite diverse settings, attendance and caseloads, MDTs adopted similar processes of case management: presentation; information seeking/sharing; narrative construction; solution seeking; decision-making and task allocation. Patient-centredness was evident but scope to strengthen 'patient-voice' exists. MDTs were hampered by information governance rules and lack of interoperability between patient databases. Meetings were characterised by mutual respect and collegiality with little challenge. Decision-making appeared non-hierarchical, often involving dyads or triads of professionals. 'Added value' lay in: rapid patient information sharing; better understanding of contributing agencies' services; planning strategies for patients that providers had struggled to find the right way to engage satisfactorily; and managing risk and providing mutual support in stressful cases.

conclusionsMore attention needs to be given to removing barriers to information sharing, creating scope for constructive challenge between staff and deciding when to remove cases from the caseload.

Indexed as

Patient Care TeamSocial SupportAgedEnglandHumansMulti-disciplinary teams; health and social care integration; non-participant observation

Identifiers

PMID35676685
PMCPMC9175164

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.