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Mirror meetings with frail older people and multidisciplinary primary care teams: Process and impact analysis
Sietske Grol1, Gerard Molleman1,2, Henk Schers1
1Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands.
Objectives:
To analyse the process and impact of confronting multidisciplinary teams (MTs) in primary care with the experiences of frail older patients through mirror meetings (MMs), with the aim of supporting teams to organize care in a more patient-oriented way.
Methods:
Process and impact analyses were performed using a mixed-method approach. MMs were held with 14 frail older patients and four MTs comprising 23 health-care professionals (HCPs) in primary care in the Netherlands.
Results:
Mirror meetings were feasible for frail older people living at home, although their recruitment was time-consuming. Interaction between the patients was scarce, but they valued the opportunity to share their stories. HCPs preferred MMs overwritten reports about patient experiences. An impact analysis revealed four dominant professional areas for improvement: improve alignment with patient goals, improved communication with patients both orally and in writing, developing new pathways to connect with informal caregivers and an increased understanding that most HCPs are relative strangers to their patients.
Conclusions:
Mirror meetings are a relatively simple and promising method for exploring the ways in which frail older patients experience care.
Practice Implications:
Given the right conditions, MMs could result in valuable processes to enable MTs to improve their working methods.
Insights
Mirror meetings (MMs) effectively engaged frail older patients with primary care multidisciplinary teams (MTs). MMs revealed key areas for improving patient-centered care, enhancing communication, and aligning with patient goals.
Area of Science:
- Gerontology
- Primary Care Medicine
- Health Services Research
Background:
- Frail older patients often experience fragmented care within primary care settings.
- Multidisciplinary teams (MTs) in primary care require effective methods to understand patient perspectives.
- Patient-centered care models necessitate incorporating patient experiences into team practices.
Purpose of the Study:
- To analyze the process and impact of using mirror meetings (MMs) to connect multidisciplinary teams (MTs) in primary care with the experiences of frail older patients.
- To support primary care MTs in organizing care in a more patient-oriented manner.
Main Methods:
- A mixed-method approach was employed for process and impact analyses.
- Mirror meetings (MMs) were conducted with 14 frail older patients and four primary care MTs (23 healthcare professionals) in the Netherlands.
- Feasibility of MMs for home-dwelling frail older individuals was assessed.
Main Results:
- MMs were feasible for frail older patients, though recruitment presented challenges.
- Patients valued sharing their experiences, despite limited interaction.
- Healthcare professionals (HCPs) preferred MMs over written reports.
- Impact analysis identified four key improvement areas: goal alignment, communication (oral and written), informal caregiver engagement, and HCPs' understanding of their patient relationships.
Conclusions:
- Mirror meetings (MMs) offer a simple and promising method for understanding frail older patients' care experiences.
- When implemented under appropriate conditions, MMs can facilitate valuable processes for MTs to enhance their working methods.
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