Borgstrom Erica, Cohn Simon, Driessen Annelieke
Faculty of Wellbeing, Education and Language Studies, School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK.
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Health Sociol Rev. 2025 Mar;34(1):77-91. doi: 10.1080/14461242.2024.2432881. Epub 2024 Dec 31.
Multidisciplinary team meetings are part of the everyday working life of palliative care staff. Based on ethnographic material from community and hospital palliative care teams in England, this article examines these meetings as dynamic routines. Although intended to have a prescribed format to review deaths and collect standardised information to monitor service performance, in practice, the content and conduct of the meetings were fluid, reflecting how this structure did not always match the concerns held by the team. The meetings provided a means for the team to collectively enact and weigh up different values through distributing the care and responsibility for individual patients across the team; jointly 'feeling their way' to determine what care should be offered and in what form; and by caring for their own professional wellbeing in the context of metric-driven healthcare. We observed how staff experienced tensions in 'documenting care' because of a concern that this misrepresented what they felt were core aspects of their role. Whilst team meetings may be considered a formal, routine part of teamwork and care, we interpret them as a dynamic social practice during which palliative care teams continually question 'what really matters' and (re)make what palliative care practice should entail.
多学科团队会议是姑息治疗工作人员日常工作的一部分。基于来自英国社区和医院姑息治疗团队的人种志资料，本文将这些会议视为动态惯例进行考察。尽管这些会议旨在采用规定的形式来回顾死亡情况并收集标准化信息以监测服务表现，但在实际操作中，会议的内容和流程是灵活多变的，这反映出这种结构并不总是与团队所关注的问题相契合。会议为团队提供了一种方式，通过在团队成员间分配对个体患者的护理和责任，集体践行并权衡不同的价值观；共同“摸索前行”以确定应提供何种护理以及采取何种形式；并在以指标为导向的医疗环境中关注自身的职业福祉。我们观察到工作人员在“记录护理情况”时如何因担心这会歪曲他们所认为的自身角色的核心方面而感到紧张。虽然团队会议可能被视为团队协作和护理工作的一个正式常规部分，但我们将其解读为一种动态社会实践，在此过程中，姑息治疗团队不断质疑“真正重要的是什么”，并（重新）塑造姑息治疗实践应包含的内容。
