What Is Best Way To Structure Interdisciplinary Hospital Team Work?

Samuel Pannick, MA, MBBS, MRCP Imperial Patient Safety Translational Research Center, National Institute for Health Research and Imperial College London, London, England West Middlesex University Hospital National Health Service Trust, Middlesex, EnglandMedicalResearch.com Interview with:
Samuel Pannick, MA, MBBS, MRCP
Imperial Patient Safety Translational Research Center, National Institute for Health Research and Imperial College London
West Middlesex University Hospital National Health Service Trust Middlesex, England

Medical Research: What is the background for this study? What are the main findings?

Response: Improving the quality of general medical ward care is a recognized healthcare priority internationally. Ward teams have been encouraged to structure their work more formally, with regular interdisciplinary team meetings and closer daily collaboration with their colleagues. Some early studies suggested that these changes might benefit patients, and help ward teams work more efficiently. However, team interventions on medical wards have been reported with numerous different outcome measures, and prior to this study, it was unclear what their objective benefits were.

We showed that there is little agreement on the objective outcomes that best reflect the quality of interdisciplinary team care on general medical wards. Changes to interdisciplinary care aren’t reflected in the outcome measures that researchers choose most often, like early readmission rates or length of stay. Complications of care – although harder to record – might have more promise as a measure of the quality of inpatient team care in these specific medical areas.

Medical Research: What should clinicians and patients take away from your report?

Response: Interdisciplinary work in general medicine remains one of the most important – and enjoyable – components of patient care. However, it’s vital that we don’t try to assess team performance against inappropriate quality metrics. More nuanced measures require more resources for data collection, but will ultimately give a truer picture of the quality of the care.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Future research should establish a core set of outcomes that better reflect the quality of general medical ward care. With these measures in place, new studies can then focus on how interdisciplinary team care interventions are implemented – an important factor in their success. Ultimately, we need to understand the preconditions for good interdisciplinary care, and the way it interacts with other elements of good practice.

Citation:

Pannick S, Davis R, Ashrafian H, et al. Effects of Interdisciplinary Team Care Interventions on General Medical Wards: A Systematic Review. JAMA Intern Med. Published online June 15, 2015. doi:10.1001/jamainternmed.2015.2421.

Samuel Pannick, MA, MBBS, MRCP, & Imperial Patient Safety Translational Research Center, National Institute for Health (2015). What Is Best Way To Structure Interdisciplinary Hospital Team Work?

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