SKILLS & LEARNING
EFFECTIVE MULTIDISCIPLINARY TEAM WORK Nikki Brierley Specialist Dietitian and CBT Therapist
An effective multidisciplinary team (MDT) is an essential part of delivering person-centred care and is associated with positive treatment outcomes. MDT working involves utilising the knowledge, skills and best practice from various disciplines and service providers.
Nikki has been a HCPC Registered Dietitian for eight years and more recently gained BABCP accreditation as a CBT Therapist. She currently works in a dual role within the Adult Community Eating Disorder Service at Cheshire and Wirral Partnership NHS Foundation Trust.
The key traits of successful MDT working have been identified as leadership, relationships, culture, clinical engagement, developing workforce, information, communication and commissioning. However, it is suggested that the most important guiding principle for MDT working is a shared commitment to delivering person centred and coordinated care. Care co-ordination is directly correlated with successful MDT working and improved long-term outcomes. It is suggested that key skills are required to undertake the role of care co-ordination, but that the clinical background or organisational base of the individual is less important. The elements required and the role of the care coordinator are summarised in table 1.
There is also an argument that the patient themselves is encouraged and supported to become their own care coordinator, with the aim of promoting independence and resilience in line with the underlying ethos of integrated care.1 IDENTIFYING AND OVERCOMING POTENTIAL BARRIERS
When introducing MDT working there are inevitable barriers which may present, it is important that these are acknowledged and overcome to ensure effective MDTs can be established and maintained. Indeed, part of the NHS 5 year forward view (2) requires that the traditional boundaries that exist between services are dissolved and the obstacles that prevent personalisation and coordination of health services be removed. Table 2 lists the potential barriers to MDT working.
Table 1: The role of care coordinator Form a proactive working relationship with the patient. Complete a holistic, person-centred assessment with the patient. Provide a central and continuous point of contact for the patient and professionals involved. Act as a key advocate for the patient if required. Assist the patient in the successful navigation of complex health and social systems. Demonstrate local knowledge of the range of health and care services. Take responsibility of care planning and ensure this takes place as agreed. Hold other providers within the care plan to account. Monitor and review care plans and agreed outcomes in partnership with the patient and evaluate outcomes. Provide direct care where appropriate. Adapted from NHS England MDT handbook, Jan 20151
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www.NHDmag.com March 2017 - Issue 122