Abstract
INTRODUCTION: As part of a larger quality improvement project focused on improving the management of older people living with frailty attending the Manchester Royal Infirmary, a Frailty Same Day Emergency Care Unit (Frailty SDEC) was established. This would require the merging of three teams: the Front Door Frailty team, the Acute Therapy team and an established Nursing team on the allocated ward area. It became apparent that an intervention was required to improve team-working and efficiency among these clinicians who had never all worked together in the same space before. METHODS: Board Rounds are well established elsewhere in the hospital and are recommended by the Royal College of Physicians’ Principles for Best Practice. We therefore tested, through four Plan-Do-Study-Act (PDSA) cycles, the approach to Multidisciplinary team (MDT) board rounds that would facilitate teamwork and efficiency in the team. RESULTS: Our main outcome measure was staff satisfaction. There is evidence that increased staff satisfaction improves patient outcomes; this is therefore an important metric. Furthermore, there would be other confounders on efficiency such that time to discharge would not have been an accurate measure of the impact of good board rounds. We therefore surveyed the MDT after 6 months of working through the PDSA cycles to compare the current practice with what had been the status quo at the start of the year. The overwhelming response (both quantitative and qualitative) was increased satisfaction with how the team was working together to improve patient care. CONCLUSION: When setting up a new service, early attention must be given to how to ensure that newly created teams have their own personalised approach to collaborative MDT working, by establishing a Board Round culture that works for that team.