Effect of implementation of a weekly multidisciplinary team meeting in a general intensive care unit.

OBJECTIVE

To determine whether the introduction of a weekly multidisciplinary team meeting (MDTM) to a general intensive care unit improved selected clinical indicators of patient outcome, and staff satisfaction with patient care.

DESIGN

A single-centre, observational, before-and-after study.

SETTING

A 14-bed general ICU in an urban, tertiary teaching hospital.

STUDY POPULATION

All patients admitted to the ICU during June-December 2006 (before the intervention) and June- December 2007 (after the intervention), and staff employed in the ICU in December 2006 and December 2007.

INTERVENTION

Introduction of a weekly MDTM to the ICU.

MAIN OUTCOME MEASURES

The primary outcome was the number of patients who stayed in the ICU longer than 5 days. Secondary outcomes included nurses' scores for satisfaction with patient care on a questionnaire; ICU and hospital mortality; duration of mechanical ventilation; readmissions to the ICU within 72 hours of discharge; and after-hours discharges.

RESULTS

There were 376 ICU admissions in the "before" period and 432 in the "after" period. Baseline characteristics of the two groups were similar except for a lower proportion of patients admitted directly to the ICU from the operating theatres in the after period (34.2% v 45.2%, P = 0.002). There were no significant differences in any of the primary or secondary outcomes, with the exception of one questionnaire score: a fall in the score nursing staff gave for value of all meetings held in the ICU following the introduction of the MDTM (from 6.6 to 3.9 on a scale of 0-10, P = 0.001).

CONCLUSION

The introduction of a weekly MDTM to a general ICU did not improve selected clinical indicators of patient outcome or staff satisfaction with patient care.