Virtual MDT in care homes during COVID-19

Varinder Rai, Regional Medicines Information Manager, London Medicines Information ServiceExample from Amy Bradley, Senior Clinical Pharmacist – West Integrated Pharmacy Team & Community , Northumbria Healthcare NHS Foundation TrustPublished
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Overview

Summary

During the Covid 19 pandemic it was vital to develop safe new ways of providing services to care home residents, whilst face to face interaction was limited. Prior to the pandemic we had an existing rolling programme of multi-disciplinary team (MDT) meetings in the nursing homes within our locality. In order to continue service provision we developed a virtual MDT set-up, utilising Microsoft Teams to facilitate remote discussion and review of residents. The virtual MDT is attending by the full multi-disciplinary team including care home staff, nominated GP, hospital geriatrician, specialist community matron for nursing homes and senior clinical pharmacist.

Why this example is important

This example illustrates that it is possible to maintain patient-centred, holistic, multi-disciplinary team reviews of care home residents in a virtual manner to enhance patient safety while minimising face to face contact during the pandemic. Some form of restrictions are likely to exist for some time, and it is important to continue to optimise care for vulnerable patients and minimise unnecessary hospital admissions.

Implementation

What were you hoping to achieve?

We were hoping to continue the existing nursing home MDT programme in light of current Covid 19 restrictions, to ensure patient safety.

What have you implemented

A variety of technological solutions were tested to determine the optimal solution. These included a socially distanced face to face meeting between MDT members with a voice-call to care home, the use of the GP records based Accurx videocall (limited as there is a restriction on number of callers) and using a voice-only telephone conference dial-in number.

The final method, chosen for ease, security and similarity to the conventional face to face model, was the Microsoft Teams video-conference function. This is easily accessible once downloaded, and it is simple to start the meeting. It is also approved for use within the NHS and is a secure channel for patient identifiable data.

We have now resumed our rolling programme of MDT meetings with each nursing home.

What have you achieved?

We have successfully continued the nursing home MDT programme with the existing members, by creating a virtual MDT format using MS Teams. In addition, the new way of working is time-efficient as it eliminates the requirement for team members to travel to each care homes, some of which are in remote locations within the county. Additional benefits are that this format allows for real-time changes to GP records and prescriptions, and immediate access to hospital electronic records whilst on the virtual MDT call.

Challenges and tips for adoption

The main challenge is the technology, in particular getting this set-up within the care homes. The top tip would be to test the technology in advance of the first meeting with each care home, and also to accept that there may be some connection issues initially. Try to identify a key member of staff at each care home to lead on the project, as they will help drive it forward. It can also be a challenge to align schedules for all team members, so try to arrange meetings in plenty of time to allow amendments of appointment bookings etc.