Increasing the Efficiency Of Community Mental Health Team (CMHT) MDT Meetings in Birmingham & Solihull Mental Health NHS Foundation Trust (BSMFT)

Abstract

AimsMultidisciplinary team (MDT) meetings provide a timely opportunity per week where a range of professionals involved in the service user's care come together to discuss patients and make an informed decisions as a team. With an increase in psychiatry community mental health team (CMHT) caseload (referrals in March 2021 were +5%), it is paramount we think of more efficient ways of running routine CMHT practises. Our aim was to identify the inefficiencies that surround the Aston & Nechelle's weekly MDT meetings & derive feasible modifications to make the protected team discussion time more efficient.MethodsThe PDSA (Plan-Do-Study-Act) cycle quality improvement methodology was used. A mixed qualitative & quantitative methodology was utilised. An observational study was carried out pre-intervention by two new members over 20 MDT meetings. Qualitative data were collected by identifying the key delays in MDT. Comparison of pre-intervention & post-intervention efficiency was established by quantifying the percentage of MDTs overrunning their allocated time. Satisfaction of the MDT members (n=10) with the new practise was also recorded via a questionnaire post-intervention. Our data collectors identified three main primary drivers: Systems, process & documentation.ResultsThe interventions under process included a structured agenda, table of patients for discussion & allocating designated roles within MDT. The primary driver of System, focused on creating AccurX proformas as a way to ease the use of AccurX (an integrated software program in Rio for securely contacting patients) during MDT. MDT members were trained informally to use AccurX & Smartcard (NHS spine search for patient demographic details). Finally, a standardised documentation style was trialled by creating proformas with a streamlined set of options under each agenda.Pre-intervention showed that >90% of MDTs were starting late & >50% were running over the allocated time. Post QI implementations, 80% of MDTs ran within allocated time. 90% of people found the MDT has increased efficiency, with 30% rating it as ‘very efficient’.ConclusionThe current CMHT MDT meetings have scope for more efficient practises. We should consider feasible modifications in the realm of system, process & documentation as a stepping stone to increase efficiency. This QI project suggests benefits for the wider implementation of such interventions to other CMHTs within the area.