The effect of a structured model for stroke rehabilitation multi-disciplinary team meetings on functional recovery and productivity: a Phase I/II proof of concept study

Abstract

Objective: Regular multidisciplinary team meetings are the main way that teams operate, yet our earlier research found they can sometimes be suboptimal. We developed a model to structure multidisciplinary team meetings and assessed the feasibility, acceptability and impact of its implementation on meeting quality and patient outcomes.

Design: Longitudinal cohort design with non-participant observation of multidisciplinary team meetings before and after implementation of the intervention.

Setting: Inpatient stroke rehabilitation units.

Subjects: Members of the multidisciplinary inpatient stroke rehabilitation teams.

Intervention: A model to structure multidisciplinary team meetings.

Main measures: Quality of multidisciplinary team meetings (using a predefined checklist); change in independence (Barthel Index) during admission; length of stay; meeting duration and the number of patients discussed.

Results: At baseline, meeting quality was generally low. Following implementation, all aspects of meeting quality improved by 5%-58%. This was achieved without loss of staff productivity or additional resources: The mean number of patients treated during the observation periods was 36 (SD 17.6), which was unchanged after implementation. Nor were there any significant changes in the length of meetings (mean = 76 minutes), time spent discussing each patient (5.4 vs. 7 minutes) or length of stay (26.7 vs. 30.3 days), but there was a greater increase in Barthel Index score after implementation (3.8 vs. 4.7) indicating greater functional recovery.

Conclusions: A feasible and acceptable model to structure multidisciplinary stroke team meetings has been developed and implemented. This increased meeting quality without increase in resources and may increase patient recovery.

Keywords: Rehabilitation; meetings; multidiscipliary team; stroke.