Exploring multi-disciplinary team meetings on a personality-disorder ward within a forensic setting
| DOI | https://doi.org/10.1108/MHRJ-05-2019-0017 |
| Date | 29 August 2019 |
| Pages | 160-170 |
| Published date | 29 August 2019 |
| Author | Maggie Leese,Kim Fraser |
| Subject Matter | Health & social care |
Exploring multi-disciplinary team meetings
on a personality-disorder ward within a
forensic setting
Maggie Leese and Kim Fraser
Abstract
Purpose –The purpose of this paper is to understand how patients on a low security personality disorder
ward experienced multi-disciplinary team (MDT) meetings, in order to suggest improvements that would
benefit the patients and clinical teams.
Design/methodology/approach –The design was a case study where all patients on a low secure ward that
specialised in personality disorders were approached to take part in the research. The study utilised non-participant
observations of the MDT meeting (n ¼11), followed by individual interviews with the patients (n ¼10).
Findings –The data were subjected to a thematic analysis and this illuminated five themes relating to the
patients’experience of the MDT meetings namely, the importance of leave applications, the formality of the
meetings, the opportunity to check on progress, decision-making and the importance of communication.
Practical implications –The findings suggest that small changes could be made to improve the patients’
experience of the MDT meeting. These included the provision of a less formal setting, ensuring a system
where leave can be requested confidentially, greater transparency about the content of progress reports, and
clearer communication between the MDT and the patient after the meeting.
Originality/value –There is limited research that has explored patients’experiences of MDT meetings within
secure forensic settings, and the use of non-participant observations of the MDT meeting followed by
semi-structured interviews meant that the researcher and the patient had a shared experience that formed
the basis of the later discussion.
Keywords Forensic, Personality disorder, Decision-making, Multi-disciplinary team, Patient experiences
Paper type Research paper
Introduction
The weekly “ward rounds”, or what has more recently become known as multi-disciplinary team
(MDT) meetings (Fiddler et al., 2010; Lyall and Bartlett, 2010), are an important aspect of patient
care and play an important role in reviewing treatment plans, measuring progress and are critical
to the decision-making process (Raine et al., 2015). Studies have highlighted that while patients
on a physical health ward were positive about their experience of MDT meetings, mental health
patients expressed more scepticism (O’Driscoll et al., 2014). Earlier studies have noted that
attendance at these meetings can lead to anxiety in some patients (Foster et al., 1991), possibly
because they are unprepared and unclear about what will be discussed (White and Karim, 2005).
Studies have also highlighted that patients can feel intimidated and distressed at the prospect of
attending a ward round meaning that it is essential to ensure that research explores patients’
experiences (Wagstaff and Solts, 2003). In their study, Milner et al. (2008) utilised a questionnaire
to explore patients and staff perspectives on the purpose of the MDT meeting and they found
that 57 per cent of patients were unaware of their structure and purpose of the meetings.
Perhaps more surprisingly, they found that 49 per cent of staff were also unclear about this.
A recent study by Haines in 2018 noted that decision-making within the MDT meetings had an
unequal preference towards the values and assumptions of the staff. Furthermore, Haines
Received 22 May 2019
Revised 28 June 2019
Accepted 12 July 2019
The authors wish to sincerely
thank the patients who co-
operated so willingly with this
study. The authors are also
grateful to the staff who were
uncomplaining of the disruption to
their routines by the process of the
study. This authors did not receive
any funding for this study.
Maggie Leese is based at the
Teesside University,
Middlesbrough, UK.
Kim Fraser is based at the
Cheswold Park Hospital,
Doncaster, UK.
PAGE160
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MENTALHEALTH REVIEW JOURNAL
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VOL. 24 NO. 3 2019, pp. 160-170, © Emerald Publishing Limited, ISSN 1361-9322 DOI 10.1108/MHRJ-05-2019-0017
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