Multidisciplinary group performance—measuring integration intensity in the context of the North West London Integrated Care Pilot

2.50
Hdl Handle:
http://hdl.handle.net/10547/582870
Title:
Multidisciplinary group performance—measuring integration intensity in the context of the North West London Integrated Care Pilot
Authors:
Harris, Matthew; Greaves, Felix; Gunn, Laura; Patterson, Susan; Greenfield, Geva; Car, Josip; Majeed, Azeem; Pappas, Yannis
Abstract:
Introduction: Multidisciplinary Group meetings (MDGs) are seen as key facilitators of integration, moving from individual to multidisciplinary decision-making, and from a focus on individual patients to a focus on patient groups. We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot. Methods: We defined ‘integrating’ as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken. Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures—the Valence, the Focus, and the Level. Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity. Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score. Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described. Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating. The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values.
Affiliation:
Imperial College London; Royal Brisbane and Women’s Hospital
Citation:
Harris, M., Greaves, F., Gunn, L., Patterson, S., Vaschitz, G., Car, J., Majeed, A., Pappas, Y. (2013) 'Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot' International Journal of Integrated Care, 13.
Publisher:
Igitur Publishing
Journal:
International Journal of Integrated Care
Issue Date:
2013
URI:
http://hdl.handle.net/10547/582870
PubMed ID:
23687473
PubMed Central ID:
PMC3653286
Additional Links:
http://www.ijic.org/index.php/ijic/article/view/996/1960; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653286/
Type:
Article
Language:
en
ISSN:
1568-4156
Appears in Collections:
IHR Institute for Health Research

Full metadata record

DC FieldValue Language
dc.contributor.authorHarris, Matthewen
dc.contributor.authorGreaves, Felixen
dc.contributor.authorGunn, Lauraen
dc.contributor.authorPatterson, Susanen
dc.contributor.authorGreenfield, Gevaen
dc.contributor.authorCar, Josipen
dc.contributor.authorMajeed, Azeemen
dc.contributor.authorPappas, Yannisen
dc.date.accessioned2015-11-30T10:36:59Zen
dc.date.available2015-11-30T10:36:59Zen
dc.date.issued2013en
dc.identifier.citationHarris, M., Greaves, F., Gunn, L., Patterson, S., Vaschitz, G., Car, J., Majeed, A., Pappas, Y. (2013) 'Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot' International Journal of Integrated Care, 13.en
dc.identifier.issn1568-4156en
dc.identifier.pmid23687473en
dc.identifier.urihttp://hdl.handle.net/10547/582870en
dc.description.abstractIntroduction: Multidisciplinary Group meetings (MDGs) are seen as key facilitators of integration, moving from individual to multidisciplinary decision-making, and from a focus on individual patients to a focus on patient groups. We have developed a method for coding MDG transcripts to identify whether they are or are not vehicles for delivering the anticipated efficiency improvements across various providers and apply it to a test case in the North West London Integrated Care Pilot. Methods: We defined ‘integrating’ as the process within the MDG meeting that enables or promotes an improved collaboration, improved understanding, and improved awareness of self and others within the local healthcare economy such that efficiency improvements could be identified and action taken. Utterances within the MDGs are coded according to three distinct domains grounded in concepts from communication, group decision-making, and integrated care literatures—the Valence, the Focus, and the Level. Standardized weighted integrative intensity scores are calculated across ten time deciles in the Case Discussion providing a graphical representation of its integrative intensity. Results: Intra- and Inter-rater reliability of the coding scheme was very good as measured by the Prevalence and Bias-adjusted Kappa Score. Standardized Weighted Integrative Intensity graph mirrored closely the verbatim transcript and is a convenient representation of complex communication dynamics. Trend in integrative intensity can be calculated and the characteristics of the MDG can be pragmatically described. Conclusion: This is a novel and potentially useful method for researchers, managers and practitioners to better understand MDG dynamics and to identify whether participants are integrating. The degree to which participants use MDG meetings to develop an integrated way of working is likely to require management, leadership and shared values.en
dc.language.isoenen
dc.publisherIgitur Publishingen
dc.relation.urlhttp://www.ijic.org/index.php/ijic/article/view/996/1960en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653286/en
dc.subjectintegrated careen
dc.subjectmulti-disciplinary groupsen
dc.subjectcommunicationen
dc.subjecthealth servicesen
dc.subjectL510 Health & Welfareen
dc.titleMultidisciplinary group performance—measuring integration intensity in the context of the North West London Integrated Care Piloten
dc.typeArticleen
dc.contributor.departmentImperial College Londonen
dc.contributor.departmentRoyal Brisbane and Women’s Hospitalen
dc.identifier.journalInternational Journal of Integrated Careen
dc.identifier.pmcidPMC3653286en
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