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Abstract
Objective To obtain a specialist-based consensus on the aims, format and function for MDT-driven care within an inflammatory bowel disease (IBD) service.
Design This was a prospective, multicentre study using a Delphi formal consensus-building methodology.
Setting Participants were recruited nationally across 13 centres from July to August 2014.
Participants 24 participants were included into the Delphi Specialist Consensus Panel. They included six consultant colorectal surgeons, six gastroenterologists, five consultant radiologists, three consultant histopathologists and 4 IBD nurse specialists.
Interventions Panellists ranked items on a Likert scale (1=not important to 5=very important). Items with a median score >3 were considered eligible for inclusion.
Main outcome measures Consensus was defined with an IQR ≤1. Consensus on categorical responses was defined by an agreement of >60%.
Results A consensus on items (median; IQR) that described the aims of the MDT-driven care that were considered very important included: advance patient care (5;5-5), provide multidisciplinary input for the patient’s care plan (5;5-5), provide shared experience and expertise (5;5-5), improve patient outcome (5;5-5), deliver the best possible care for the patient (5;5-5) and to obtain consensus on management for a patient with IBD (5;4-5). A consensus for being a core MDT member was demonstrated for colorectal surgeons (24/24), radiologists (24/24), gastroenterologists (24/24), nurse specialists (24/24), dieticians (14/23), histopathologists (21/23) and coordinators (21/24).
Conclusions This study has provided a consensus for proposed aims, overall design, format and function MDT-driven care within an IBD service. This can provide a focus for core members, and aid a contractual recognition to ensure attendance and proactive contribution.
- Health Service Research
- Inflammatory Bowel Disease
- Ibd
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Footnotes
Contributors PSM, NS, JG, CE and OF planned the study. PSM, NS, CE and OF conducted the survey. PSM, NS, JW, AH, JG, CE and OF reported the study. PM and OF are responsible for the overall content as guarantors.
Funding PSM, NS, CE and OF received funding from the Health Service Award, Crohn’s And Colitis UK (IBDHS/13/1) . NS (until January 2015) and JG are affiliated with the Imperial Patient Safety Translational Research Centre, which is funded by the National Institute for Health Research (NIHR), UK. NS’ research was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust. NS is a member of King’s Improvement Science, which is part of the NIHR CLAHRC (IS – CLA-0113-10022) South London and comprises a specialist team of improvement scientists and senior researchers based at King’s College London. Its work is funded by King’s Health Partners (Guy’s and St Thomas’ NHS Foundation Trust, King’s College Hospital NHS Foundation Trust, King’s College London and South London and Maudsley NHS Foundation Trust), Guy’s and St Thomas’ Charity, the Maudsley Charity and the Health Foundation. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. CE was funded by the South Devon Healthcare Charitable Fund (1052232).
Competing interests NS is the Director of London Safety and Training Solutions Ltd, which provides quality and safety training and advisory services on a consultancy basis to healthcare organisations globally. NS and JG deliver teaching and consultancy-based work on evaluating and improving MDT effectiveness and team processes for hospitals in the UK and internationally. The other authors have no conflicts to declare.
Ethics approval 13YH 0175.
Provenance and peer review Not commissioned; externally peer reviewed.