Imperial College London

DrGevaGreenfield

Faculty of MedicineSchool of Public Health

Research Fellow in Public Health
 
 
 
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Contact

 

+44 (0)20 7594 8595g.greenfield Website

 
 
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Location

 

314Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Harris:2013,
author = {Harris, M and Greaves, F and Gunn, L and Patterson, S and Greenfield, G and Car, J and Majeed, A and Pappas, Y},
journal = {INTERNATIONAL JOURNAL OF INTEGRATED CARE},
title = {Multidisciplinary integration in the context of integrated care - results from the North West London Integrated Care Pilot},
url = {http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000327717800009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202},
volume = {13},
year = {2013}
}

RIS format (EndNote, RefMan)

TY  - JOUR
AB - Background:In the context of integrated care, Multidisciplinary Group meetings involve participants from diverse professional groupsand organisations and are potential vehicles to advance efficiency improvements within the local health economy. We advance a novelmethod to characterise the communication within Multidisciplinary Group meetings measuring the extent to which participants integrateand whether this integration leads to improved working.Methods:We purposively selected four Multidisciplinary Group meetings and conducted a content analysis of audio-recorded and tran-scribed Case Discussions. Two coders independently coded utterances according to their‘integrative intensity’which was defined againstthree a-priori independent domains - the Level (i.e. Individual, Collective and Systems); the Valence (Problem, Information and Solution);the Focus (Concrete and Abstract). Inter- and intra-rater reliability was tested with Kappa scores on one randomly selected Case Discus-sion. Standardised weighted mean integration scores were calculated for Case Discussions across utterance deciles, indicating how inte-grative intensity changed during the conversations.Results:Twenty-three Case Discussions in four different Multidisciplinary Groups were transcribed and coded. Inter- and intra-rater relia-bility was good as shown by the Prevalence and Bias-Adjusted Kappa Scores for one randomly selected Case Discussion. There were differences in the proportion of utterances per participant type (Consultant 14.6%; presenting general practitioner 38.75%; Chair 7.8%; non-presenting general practitioner 2.25%; Allied Health Professional 4.8%). Utterances were predominantly coded at low levels of integrativeintensity; however, there was a gradual increase (R2= 0.71) in integrative intensity during the Case Discussions. Based on the analysis ofthe minutes and action points arising from the Case Discussions, this improved integration did not translate into actions moving for
AU - Harris,M
AU - Greaves,F
AU - Gunn,L
AU - Patterson,S
AU - Greenfield,G
AU - Car,J
AU - Majeed,A
AU - Pappas,Y
PY - 2013///
SN - 1568-4156
TI - Multidisciplinary integration in the context of integrated care - results from the North West London Integrated Care Pilot
T2 - INTERNATIONAL JOURNAL OF INTEGRATED CARE
UR - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000327717800009&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR - http://hdl.handle.net/10044/1/45563
VL - 13
ER -