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The influence of objective measurement tools on communication and clinical decision making in neurological rehabilitation.

Authors :
Tyson, Sarah F.
Greenhalgh, Joanne
Long, Andrew F.
Flynn, Robert
Source :
Journal of Evaluation in Clinical Practice; Apr2012, Vol. 18 Issue 2, p216-224, 9p, 1 Chart
Publication Year :
2012

Abstract

Rationale Routine collection of outcome measures is advocated to improve quality of care. However, there has been scant investigation of how measurement tools are used in clinical practice and what impact they may have. This paper compares two neuro-rehabilitation teams, one which routinely used standardized measurement tools and the other which did not. We explore differences in communication and clinical decision making within multidisciplinary team (MDT) meetings to illuminate the influence measurement tools could have on clinical practice. Method Non-participant observation of MDT meetings in two neurological rehabilitation units in England. Semi-structured interviews were also carried out with at least one member of each profession in each team. Grounded theory techniques were used to analyse the data. Results Differences in team members' communication within MDT meetings underscored differences in the process of clinical decision making within the teams. Using measurement tools provided a shared understanding to facilitate communication by focusing discussion on the patient's abilities rather than individual professionals' contributions. This led to differences in the way team members identified the nature and cause of patients' problems, monitored their progress and planned for discharge. They provided a 'neutral ground' to reach a shared perspective between professionals, thereby avoiding conflict. Externally, use of the tools enabled objective discussion with patients and their families about their progress and was a vehicle to facilitate giving bad news. Conclusion Using standardized measurement tools can promote a patient-focused approach to care, thus facilitating treatment planning and clinical decision making. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13561294
Volume :
18
Issue :
2
Database :
Complementary Index
Journal :
Journal of Evaluation in Clinical Practice
Publication Type :
Academic Journal
Accession number :
72417245
Full Text :
https://doi.org/10.1111/j.1365-2753.2010.01555.x