Multidisciplinary team meetings: dynamic routines that (re)make palliative care.

Abstract

Multidisciplinary team meetings are part of the everyday working life of palliative care staff. Based on ethnographic material from community and hospital palliative care teams in England, this article examines these meetings as dynamic routines. Although intended to have a prescribed format to review deaths and collect standardised information to monitor service performance, in practice, the content and conduct of the meetings were fluid, reflecting how this structure did not always match the concerns held by the team. The meetings provided a means for the team to collectively enact and weigh up different values through distributing the care and responsibility for individual patients across the team; jointly 'feeling their way' to determine what care should be offered and in what form; and by caring for their own professional wellbeing in the context of metric-driven healthcare. We observed how staff experienced tensions in 'documenting care' because of a concern that this misrepresented what they felt were core aspects of their role. Whilst team meetings may be considered a formal, routine part of teamwork and care, we interpret them as a dynamic social practice during which palliative care teams continually question 'what really matters' and (re)make what palliative care practice should entail.