Why Interdisciplinary Teamwork in Healthcare is Challenging
By Rose O. Sherman, EdD, RN, FAAN
“It is no longer enough for health workers to be professional. In the current global climate, health workers also need to be interprofessional.” World Health Organization 2010
The ability to effectively work on an interdisciplinary team is a major focus today in the education of future health care professions in all disciplines. Interprofessional education (IPE) is the new buzzword in academic environments and many education grants now require that IPE is incorporated into training plans. Several weeks ago, I was part of an interdisciplinary team of faculty that developed an IPE educational experience focused on health reform. We provided a scenario and asked our teams of medical, nursing and social work students to design a care transitional program that would reduce 30 day hospital re-admissions of Medicare patients. I was reminded during these sessions about why interdisciplinary teamwork is often very challenging in practice environments. Five key lessons I learned included the following:
* Interdisciplinary Teamwork Needs to be Clearly Defined as a Future Professional Expectation
A team is sometimes described as a small number of people with complementary skills who are committed to a common purpose and goals. On interdisciplinary teams, decisions are reached collectively by the group. It is this collective decision making that makes the interdisciplinary team different than a multidisciplinary team where there is more parallel play and one person usually makes the treatment decisions. The concept of everyone being involved and participating is key to effective interdisciplinary work. In our IPE work, we did find that there are students who have not yet begun their professional careers that resist efforts to be involved in interdisciplinary teamwork.
* Acknowledge the Unique Culture, Language and Mental Model in each Discipline
Each discipline has a unique culture, language and also a mental model in how they approach patient situations. Allowing the students to discuss their perceptions of the case scenario was very important and highlighted the differences in approach to the care of geriatric patients.
* Defining a Common Goal is a Critical Success Factor
Teams can sometimes assume they are working on a common goal without defining it. This was certainly true in our scenario before the facilitators pointed out the importance of goal setting. Our medical students were most interested in making sure that patients had received adequate treatment to prevent readmission. The social work and nursing students had a clearer understanding of the range of transitional care issues that needed to be considered beyond the medical care.
* Don’t Assume Professionals Understand the Work of Other Disciplines
A key success factor in interdisciplinary teamwork is an understanding of the unique knowledge, skills and abilities that each discipline brings to the team. After reviewing the scenario,we asked the students in each discipline to describe what their role could be in the achievement of the common goal. Students are often surprised about the knowledge and clinical abilities of other disciplines. Many of our students did not know that today’s pharmacy graduates are doctorally prepared and can capably do much of the chronic medication management for certain groups of patients.
* Spend Time Discussing the Benefits of Interdisciplinary Teamwork
We can sometimes assume that professionals will see the value in interdisciplinary teamwork without being explicit about the benefits. In our exercises, we needed to help the students see the value in collective knowledge and talents. This is important because finding the time to arrange for interdisciplinary meetings can be daunting in health care environments. Interdisciplinary teamwork is an important component in reducing health care costs, promoting patient safety through more effective communication and can help reduce workload through shared responsibility. We also promoted the personal satisfaction and friendships that can evolve from being on a highly functioning team.
As I observed our students working together on their teams, I realize that this interprofessional education work is very valuable. Historically, we have not taken the time to require disciplines to work together on a regular basis before they enter practice settings. It is not surprising that we see the communication breakdowns that are common in today’s health care settings. IPE education is just the beginning – teamwork takes practice and these efforts also need to take place in practice settings.
Read to Lead
IPEC Expert Panel. (May 2011). IPE Core Competencies
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