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The influence of objective measurement tools on communication and clinical decision making in neurological rehabilitation

Tyson, S, Greenhalgh, J, Long, A and Flynn, R 2010, 'The influence of objective measurement tools on communication and clinical decision making in neurological rehabilitation' , Journal Of Evaluation In Clinical Practice, 17 (3) .

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    Abstract

    Rationale: routine collection of outcome measures is advocated to improve quality of care. However, there has been scant investigation of how measurement tools are used in clinical practice and what impact they may have. This paper compares two neurorehabilitation teams, one which routinely used standardized measurement tools and the other which did not.We explore differences in communication and clinical decision making within multidisciplinary team (MDT) meetings to illuminate the influence measurement tools could have on clinical practice. Method: non-participant observation of MDT meetings in two neurological rehabilitation units in England. Semi-structured interviews were also carried out with at least one member of each profession in each team. Grounded theory techniques were used to analyse the data. Results: differences in team members’ communication within MDT meetings underscored differences in the process of clinical decision making within the teams. Using measurement tools provided a shared understanding to facilitate communication by focusing discussion on the patient’s abilities rather than individual professionals’ contributions. This led to differences in the way team members identified the nature and cause of patients’ problems, monitored their progress and planned for discharge. They provided a ‘neutral ground’ to reach a shared perspective between professionals, thereby avoiding conflict. Externally, use of the tools enabled objective discussion with patients and their families about their progress and was a vehicle to facilitate giving bad news. Conclusion Using standardized measurement tools can promote a patient-focused approach to care, thus facilitating treatment planning and clinical decision making.

    Item Type: Article
    Uncontrolled Keywords: clinical decision making, communication, neurological rehabilitation, outcome measures
    Themes: Health and Wellbeing
    Schools: Colleges and Schools > College of Health & Social Care > School of Health Sciences > Centre for Health Sciences Research
    Colleges and Schools > College of Health & Social Care
    Colleges and Schools > College of Health & Social Care > School of Health Sciences
    Journal or Publication Title: Journal Of Evaluation In Clinical Practice
    Publisher: Blackwell Publishing
    Refereed: Yes
    ISSN: 1356-1294
    Depositing User: RH Shuttleworth
    Date Deposited: 08 Jun 2011 13:01
    Last Modified: 20 Aug 2013 17:54
    URI: http://usir.salford.ac.uk/id/eprint/15971

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