Multidisciplinary health professionals' assessments of risk: how are tools used to reach consensus about risk assessment and management?

Author accepted manuscript (Post-Print) made available in accordance with publisher copyright policy.Risk assessment and management are among the most important and complex tasks health professionals undertake in their practice to prevent harm to patients and ensure safe and effective treatment. The aim of this study was to examine how multidisciplinary team members use tools to assess and manage risk, through examination of how tools are used to gather, record and “score” risk information; and how this process impacts on the formulation of risk assessment and management plans, interaction with patients, and consensus with colleagues regarding patient care. Fourteen professionals completed an assessment for a hypothetical client using a risk assessment and management tool, and then discussed their assessment in semi-structured interviews. Professionals were in moderate agreement in their assessments of the client on the tool, and highlighted the complexity of their decision making. Clinical management decisions, such as the amelioration of particular risks, followed assessment of the patient in a consistent way. The tool was an important way to for clinicians to communicate their judgments to others and set plans to direct patient care. Implications for the use of clinical decision making tools and instruments in mental health care, and the need for a focus on multidisciplinary decision making, are highlighted