5: Building a Strong Foundation
Issues to Discuss
At this point, your community has discussed a number of meta-issues such as organizational structure and MDT members. In this chapter, more micro-level issues are raised for discussion. Ultimately, these decisions will form the foundation for writing protocols that will articulate members’ responsibilities and ensure consistency in their work, but for now, your community can discuss the various options associated with each of the issues listed in the Toolkit item: Issues for Initial MDT Discussions.
Take the Time
Be prepared to spend considerable time up front discussing these issues. This process takes more time than many anticipate and it may become frustrating for some members of the MDT. However, this groundwork is crucial for the functioning of the MDT.
Mission and Vision Statements
Early on, your MDT may want to develop and adopt a mission and vision statement. Each statement should be brief, one sentence if possible. There are numerous resources on the internet for developing a mission and vision statement.
Vision Statement
The MDT’s vision is a statement of its collective view of the future. An effective vision statement describes the world as it would be if your program succeeds. For example:
- We envision a world where we can all safely grow old together.
Mission Statement
The MDT may want to create a mission statement that defines its purpose. The mission statement provides the team with guidance and motivation and therefore should be a goal(s) that is moderately difficult to achieve. A mission statement should identify and include (1) the population or the issue in the community that the partnership is targeting or addressing and (2) the reason the MDT exists (in some cases, this may serve as the building block of your branding and marketing). Below are some examples of mission statements:
- The mission of PEARL is to aid and ensure the well-being of elderly and at-risk adults by working with the team to comprehensively address the needs and concerns of this population.
- Our mission is to champion justice and dignity for older adults.
- The mission of the Clackamas County Vulnerable Adult Multi-Disciplinary Team (MDT) is to develop a professional team committed to protecting elders and adults with disabilities, herein collectively referred to as “vulnerable adults.”
Linking Vision and Mission Statements
Some MDTs link their mission and vision statements in one paragraph, for example:
Our vision is a community where ______________________. To bring that vision into reality, we ________________for _______________ in the ____________________region/area/township.
These statements are critically important to the actions of the MDT, therefore take the time to develop these statements. Your vision and mission statements focus and guide your program so refer to them often when making decisions about your program and ensure that your decisions are in line with these statements. You will want to review your mission and vision statements periodically, even if you decide to retain the current version.
Strategic Planning
At some point in the future, within one year of developing the MDT, many MDTs step back and look at the bigger picture by engaging in a strategic planning process designed to guide the MDT in the coming years (typically, 3 to 5 years into the future) toward achievable goals.
The MDT members will want to think about and eventually decide on how all the team members are going to work together to achieve the stated goal(s). This formalized plan will provide guidance to the MDT, increase accountability, and engender trust. The plan will help create clarity about how the team should operate and how to achieve goals. Consider using existing templates to assist in the development of your strategic plan, and explore tools such as Logic Models and SMART Goals. Information about and examples of these planning tools are easily located online. Once created, refer frequently to the strategic plan and build in period review sessions to ensure its relevance.
Developing Policies
Eventually, your MDT may want to develop policies (distinct from protocols), but not all communities do so (see examples in the Toolkit item titled: Sample Protocols and Policies). A policy is a plan or course of action intended to influence and determine decisions, actions, and all activities that take place within the boundaries set by them. Policies to discuss include:
- Bylaws (outlining how the organization is to be governed)
- Data management
- Confidentiality
- Delivery of services
- Membership
- Code of ethics
- Employee/personnel
- Document retention and destruction
- Recruitment and selection of new members
- Finances
- Media
Plan for Ongoing Maintenance
As with any relationship, the MDT needs ongoing attention. Maintenance and growth of the MDT requires time, effort, and nurturing. Invite MDT members to provide feedback and suggestions regarding procedures and operations of the MDT, preferably at regularly scheduled times such as bi-annually. Managing an MDT requires ongoing commitment and resources, including:
- Time
- Money
- Staff
- Joint training
- Trust development and team building
- Conflict management
- Regular review of policies and procedures
Translating Decisions into Protocols
Eventually, your community may want to formalize decisions made about the issues discussed by writing protocols, which are documents that contain information about how the MDT is going to operate, i.e., the procedures. (For examples, see the Toolkit item: Sample Protocols and Policies). Procedures describe the steps taken to complete a specific function in the day-to-day operations of the organization and are critical to well-functioning MDTs. Protocols should be somewhat flexible. Too much specificity contained in the protocols can be used against the MDT under certain circumstances.
Memorandum of Understanding (MOU) or Interagency Agreement (IAA)
Having recruited members for the MDT, many communities then use a Memorandum of Understanding (MOU) or an Interagency Agreement (IAA) to formalize the MDT.
MOUs are formal agreements between two or more parties that outline the roles, responsibilities, and expectations of each party, a document that is typically reviewed and signed annually. MOUs generally are developed to ensure that the participants understand the scope and boundaries of their relationship to one another (see Toolkit item: Sample Memorandum of Understanding (MOUs), for examples).
- A formal MOU or IAA will need to be reviewed by agency attorneys and signed by all authorized representatives of the MDT that clearly commits the signed parties to the MDT model. Your community will want to discuss what to include in the MOU or IAA, for example:
- The agency’s commitment to having an appropriate person attend agreed-upon meetings and a designated back up representative who is authorized to attend meetings when conflicts in scheduling arise.
- A clear description of the process for conflict resolution.
- The explicit expectation that all relevant members of the MDT are routinely involved in investigations and/or interventions.
- A clear description of procedures for information sharing and group decision-making.
- Affirmation that the procedures are consistent with legal, ethical and professional standards of practice in the community and state.
Linkage Agreements
In addition to an MOU or IAA, you may want to develop linkage agreements with external service providers. The linkage agreement defines how the MDT will transfer relevant information to individuals who provide direct services but are not officially part of the MDT.
MDTs require ongoing care and maintenance. As part of the maintenance process, there are a number of activities that require periodic review such as your vision and mission statement, your strategic plan, and various policies and procedures. Outdated and irrelevant documents are not useful. Therefore, build review of these activities into your overall maintenance plan for the MDT.