Multidisciplinary case conference reviews: improving outcomes for nursing home residents, carers and health professionals.
OBJECTIVE
This study sought to determine whether multidisciplinary case conference reviews improved outcomes for nursing home residents, and the effects of this team approach to resident care on carers, including the hands-on carers employed by the nursing home, and health professionals.


METHODS
245 residents of three Canberra nursing homes were enrolled in this non-randomised controlled trial. The intervention consisted of sessions of three case conference reviews held between 10/4/96 and 4/12/96. These sessions were attended by the General Practitioners (GPs) of the residents discussed, the GP project officer from the ACT Division of General Practice, a clinical pharmacist, senior nursing staff, other health professionals e.g. physiotherapist, and occasionally the resident concerned or their representative. At each review, a case presentation by the resident's GP was followed by a multidisciplinary discussion of all aspects, medical and non-medical, of the resident's care. The review concluded with a management plan for the resident. In total 75 residents were reviewed.


METHODS
Medication use and cost, and mortality.


RESULTS
One month after the reviews were completed comparisons between those who were reviewed and those who were not showed non-significant reductions in medication orders, medication cost, and mortality in the reviewed group. Many of the 92 recommendations in the management plans that were carried out benefited the residents (n = 37) and/or carers (n = 24). The responses of the GPs and the Directors of Nursing to the reviews were overwhelmingly positive.


CONCLUSIONS
Recommendations arising from multidisciplinary case conferences were carried out to the benefit of patients and carers. Given the support shown by key stakeholders, multidisciplinary conferences should be used more.
King
M A
MA
Department of Medicine, University of Queensland, Princess Alexandra Hospital, Woolloongabba O 4102, Australia. m.roberts@mailbox.uq.edu.au
Roberts
M S
MS
D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D017028:Caregivers / Q000523:psychology*; D003365:Costs and Cost Analysis; D004358:Drug Therapy / Q000191:economics / Q000592:standards; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D009726:Nurses; D009735:Nursing Homes / Q000191:economics / Q000592:standards*; D010361:Patients / Q000523:psychology*; D010821:Physicians, Family; D016896:Treatment Outcome