Improving documentation of weekly multidisciplinary meetings in the department of rehabilitation medicine, singapore general hospital

Abstract

Multidisciplinary meetings (MDM) are conducted weekly in the department of Rehabilitation Medicine (RMD), SGH. Manual MDM documentation by doctors in the managing team was noted to be incomplete in terms of estimated date of discharge (EDD) and team member's input. We aim to improve the MDM documentation by including both the EDD and input from the various members of the RMD team from a baseline of 15% to 50% within 6 months. Through means of case notes review, the baseline appropriate documentation rate of the MDM was noted to be 15%. A fishbone analysis was done (please see Fig. 1 below). It was decided that the first intervention bundle would be to implement a standardized electronic template for MDM and demonstrating its use to the junior doctors every month. The second intervention bundle, which was implemented 3 months later, involved introducing a 2-page information on MDM documentation in the junior doctors’ orientation guide (soft copy) and a monthly demonstration to doctors doing the MDM documentation. After the first intervention bundle was implemented the appropriate documentation rate improved from 15% pre-intervention to 87.5% post-intervention. After the second intervention bundle was implemented, the appropriate documentation rate was sustained above 50% at 89.7%. (Please refer to Fig. 2 below). The implementation of a standardized Electronic Template for MDM documentation led to improvements in the rate of appropriate documentation of the MDM proceedings which was sustained with regular engagements with RMD doctors doing the MDM documentation.