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Research & theory

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

Authors:

Matthew Harris ,

Imperial College London, GB
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Academic Clinical Lecturer in Public Health
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Felix Greaves,

Imperial College London, GB
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Laura Gunn,

Imperial College London, GB
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Sue Patterson,

University of Queensland, AU
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Geva Greenfield,

Imperial College London, GB
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Josip Car,

Imperial College London, GB
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Azeem Majeed,

Imperial College London, GB
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Yannis Pappas

City University, GB
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Abstract

Introduction: Multidisciplinary Group meeting (MDGs) are seen as key facilitators of integration, moving from individual to multi-disciplinary 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.

How to Cite: Harris M, Greaves F, Gunn L, Patterson S, Greenfield G, Car J, et al.. Multidisciplinary group performance – measuring integration intensity in the context of the North West London Integrated Care Pilot. International Journal of Integrated Care. 2013;13(1):None. DOI: http://doi.org/10.5334/ijic.996
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Published on 22 Feb 2013.
Peer Reviewed

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