Weekly multidisciplinary case review (WMCR) based on a web page clinical summary (WPCS) as a tool to improve health team communication

Introduction

As part of a quality of care improvement at Launceston General Hospital a WMCR was implemented in a general medicine ward. The WMCR is directed at enhancing inter-disciplinary communication and improving the quality of care and education. The WMCR is attended by Doctors, Pharmacist, Nurses, Physiotherapists, Allied health, Community Nurses and Students.

Method

The WMCR is a multi-disciplinary activity and is base in the concept “all teach-all learn”. Each patient discussed in the meeting is under the care of a general medicine team. The patient discussion is based on the case presentation with the simultaneous projection of a pre-formatted WPCS (designed by the clinicians involved) completed pre-meeting and retrieved from the hospital’s intranet. During the conference any modification in the patient management is documented in this WPCS. On completion of the meeting the WPCS updates are emailed (each case as separate attachment) to all the members after the meeting.

Results

The WMCR provides the facility for combined, uniform multidisciplinary decision making. One of the first benefits seen was the immediate availability of a tabulated medication chart completed in association with the Clinical Pharmacist. This provides timely “de-prescribing” and “medication reconciliation”. Any changes in medication chart are documented with date, and reasons for the change. The WPCS has been used in many discussions and sent as an e-mail with attachment in 624 communications. The planning process based on the WMCR facilitates discharge planning for all clinicians. The average length of stay was reduced from 13.8 days in July 2007 to 9.8 days in January 2008.

Conclusion

The WMCR based on WPCS is currently used as a tool to advance the quality of care with impact in communication and decision making.