7: MDT Coordination

Good coordination by a skilled MDT Coordinator can overcome many barriers associated with an MDT.  Therefore, the MDT may want to discuss and/or write a position description for the MDT Coordinator. The following is a list of some activities your MDT might want to consider designating as the MDT Coordinator’s responsibility. 

Prior to the Meetings

• Manages case intake procedures including reviewing, approving, and prioritizing case summaries submitted for presentation (de-identifies parties before the meeting if needed).
• Provides assistance in preparing members who will be presenting a case by explaining what the presenter should expect in the meeting and helping the presenter frame the case, concerns, and requests for assistance from other team members.
• Sends out MDT meeting reminders and agendas.

At the Meetings

• Sets up the meeting room:
  • Arranges sign-in sheet/confidentiality agreement, copies of case summaries, name cards, and any other community information.
  • Coordinates food and drink.
• Sits where everyone is visible and within hearing distance, and everyone can see and hear the MDT Coordinator in order to best facilitate the meeting.
• Facilitates introductions and agency announcements.
• Reviews the confidentiality agreement with the MDT.
• Reviews discussion ground rules (e.g., raising a hand to be called on to speak, no shame-no blame).
• Directs group discussion toward the presenter’s questions by ensuring that all (or most) MDT members contribute to the discussion.
• Checks in with the presenter at the end of the discussion as to whether he/she received the assistance needed.
• Responds to previously raised issues where follow-up was requested.
• Notes issues raised at MDT meetings that need follow-up.
• Records meeting minutes using the MDT Data Collection Form (if any).
• Manages conflict and interpersonal dynamics.
• Recasts a team error into an opportunity for learning.
• Enforces confidentiality procedures (e.g., collecting and shredding documents at the end of the meeting).

After the Meetings

• Engages in follow-up and ensures MDT members are following through on their assignments.
• Oversees data entry and data tracking activities.
• Manages case follow-up calendar (as many cases are presented at the MDT meeting on multiple occasions, either for additional consultation or for outcome reporting).

Outside of the Meetings

• Reviews and purges the MDT Meeting Reminder e-mail list periodically.
• Arranges trainings (often short 30-minute trainings built into MDT meetings).
• Arranges new-member orientation.
• Presents information about the role and function of the MDT to the wider community.
• Represents the MDT at community meetings and events.
• Ensures that members adhere to the team’s policies and protocols, particularly around confidentiality and information sharing.

MDT Coordinators are boundary spanners. Boundary spanners are individuals who build connections between team members who represent different agencies and disciplines, and promote information sharing and collaboration while also working to maintain positive relationships.

Boundary spanners can see the big picture and can help the team bring multiple perspectives to bear on their team’s cases while holding the goals of the client and the team. To do this, boundary spanners must have the following skills:

• Communication skills: Pushing and pulling information from the appropriate experts at the right time, “packaging” so communication is clear and concise, and actively listening to ensure the information is understood in the same way as the expert.
• Ability to prioritize goals, information, and recommendations: Identifying goals across multiple professions and understanding conflicting goals between teams that may need to be reprioritized.
• Adaptability and tolerance: Reconciling differences and compromises between team members, translating information into terms each team member will understand to foster collaboration, and managing risks across the systems to allow the best solution to emerge.
• Big picture thinking: Understanding and acknowledging how each team member/agency fits into the larger system and contributes to overall mission objectives, and creating a shared understanding across team members.
• Coordination and leadership skills: Influencing others to work towards a common goal, initiating structure for communications and work across team members (e.g., setting up a regular meeting with a clear agenda), and supporting all team members within the MDT.

As depicted in the chart below, facilitation is a unique skill that differs from leading a presentation or a training. It emphasizes listening and guiding the team’s process. While the MDT Coordinator may be tasked with presenting information to the team from time to time, or arranging professional training, facilitating team meetings will be a critical component of your work. Below is a summary chart, followed by a description of each concept.

Presentation

• Definition: A presentation is a structured method of delivering information or ideas to an audience. It typically involves a speaker conveying a message using visual aids like slides, charts, or videos to enhance understanding. 
• Example: A lecturer explaining the impact of elder abuse using statistical data and case studies.
• Approach: Primarily one-way communication from the presenter to the audience. The presenter prepares and delivers content. Interaction is typically limited to questions and answers at the end.
• Focus: Disseminating information or ideas clearly and effectively to an audience. The primary goal is to inform.
• Deliverable: An informed audience that has gained new knowledge or insights from the presentation. Success is measured by how well the information was communicated and understood.

Training

• Definition: Training is a systematic approach to developing specific skills or competencies. It often involves hands-on activities, practice sessions, and interactive components to ensure that participants can apply what they've learned. 
• Example: A workshop where participants role-play elder abuse case review scenarios.
• Approach: Interactive and hands-on. Trainers use a variety of methods such as demonstrations, small group learning sessions, and practical exercises to engage participants. 
• Focus: Enhancing the participants' skills or competencies. The goal is for participants to learn and be able to apply what they have learned in real-life situations.
• Deliverable: Participants who have acquired new skills or knowledge and are able to apply them to their work. Success is measured by the improvement in participants' abilities.

Facilitation

• Definition: Facilitation as used in this context is the process of guiding your MDT through discussions or activities to help them achieve a shared goal. Facilitators encourage participation, manage group dynamics, and ensure that the process is inclusive and effective. 
• Example: An MDT meeting where a coordinated response plan for an elder abuse case is developed.
• Approach: Participant-centered and collaborative. The facilitator guides discussions, encourages input from all participants, and helps the group stay focused on their objectives. Techniques may include asking questions, encouraging collaboration, and consensus-building.
• Focus: Helping a group achieve a common goal or complete a task through guided discussions. The goal is to harness the collective input, resources, and ideas of the group.
• Deliverable: A group that has reached a consensus, developed a plan, or made decisions. The success is measured by the group's progress towards their goal and the quality of the outcomes.

Another responsibility that often falls largely to the MDT Coordinator is team building. To be effective in this role, it is important to understand how to build trust among team members and guide the team through the stages of team formation.  

In order for your team to effectively collaborate, they must feel a sense of psychological safety, which is defined as “A sense of confidence that the team will not embarrass, reject or punish someone for speaking up…a team climate characterized by interpersonal trust and mutual respect in which people are comfortable being themselves.” - Amy Edmondson 

Cultivating psychological safety within your MDT is crucial for ensuring that all team members feel comfortable sharing their ideas, concerns, and insights without fear of negative consequences. There are several strategies MDT Coordinators can use to promote psychological safety:

Model Situational Humility

• Acknowledge your own fallibility, and that you do not have all the answers
• Be humble and hungry for information

Encourage Proactive Inquiry

• Ask good questions
• Value curiosity

Incorporate Safety into Systems and Structures

• Internal processes invite ideas and concerns
• Designed to ensure safety and openness 

Frame the Work

• Create a rich and shared understanding of what the MDT does
• Talk about failure and the value of learning

Emphasize Purpose

• Explore why your work matters
• Talk about what is at stake

Express Appreciation

• Engage in active listening
• Express gratitude for bringing ideas, questions, and feedback

Destigmatize Failure

• Prioritize learning over execution
• Appreciate the bearer if not the news
• Offer help and support for next steps

Respond to Violations

• Clarify boundaries
• Ensure appropriate accountability
• Respond to concerns