The Patient, the Multidisciplinary Team and the Assessment

Abstract

CGA is powerful. It encompasses a systematic approach to assessments, a patient-centred approach to goal setting and a collaborative team approach to both these plus treatment and follow-up. Standardised assessment tools and scales are useful, but it is important to understand their best uses and their potential for abuse. Different systems of scaling require different approaches to interpretation and statistical analysis. Within the overarching notion of CGA are included less intense assessments such as screening tools and broad and deep intensive assessments as are needed for many clinical encounters in acute care and long-term care. Tools which are useful for screening will not be sufficiently explanatory for care planning. CGA lends itself to the development of clinical prediction tools which can inform service design, explain causative relationships and sometimes help individual clinical decision-making. But caution is needed in the application of these tools in contexts in which they were not developed. The impact of CGA on clinical and service outcomes depends on the skills and composition of clinical teams and how effectively they work together. Experience and empirical research has helped an understanding of how to achieve optimal collaboration.