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According to the respondents, data reuse and analytics increasingly drive the research agenda, but are obviously dictated by the availability and accessibility of data as well as the quality and clarity of documentation.
We analysed the decisions made, attendance at meetings, clarity of documentation, costs, case re-discussions and deviations from MDM decisions.
These studies may also indicate a need for improved clarity of documentation by the parent medical team with respect to the extent and aggressiveness of medical interventions in deteriorating patients.
These data included time from MDM discussion to initiation of treatment, instances of treatment initiation before MDM discussion, clarity of documentation of MDM decision, number of case re-discussions, reasons for delay in discussion or decision making relating to pathology or radiology and the cost of the individual MDMs.
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Sometimes the lack of clarity on documentation was heightened by the fact that the woman wanted to make a statement in extremis.
"I guess the presence and clarity of the documentation [is the driver].
In addition, detailed feedback was obtained from the pilot study participants about their experiences, which proved very helpful in planning appropriate scheduling and timing of assessments, the clarity of research documentation and the usefulness and design of prompt cards.
Physicians believed that the EMR improved the quality and clarity of the documentation, for example, "it is very helpful, very readable, better than the handwriting"; another example, "previously they were usually write their own abbreviations 'LE'RE'RE' not sure what they mean is it LEFT EYE or the disease itself but now because of the system coding they tend to write" (FG2).
When the POSS was used, there was an increase in both the clarity and frequency of documentation when sedation was assessed.
After each meeting, field notes were written on MDT features (eg, agenda, attendee job titles, presence of an MDT coordinator), context (eg, reference to national policy/guidance and local resource issues) and process (eg, levels of participation, role of the chair, complexity and uncertainty of problem, and clarity and documentation of decisions).
Responses clustered into three subthemes: consistency of interprofessional communication, role clarity, and documentation.
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