Transcript Module 20. Interdisciplinary Collaboration for Elder Care

Interdisciplinary
Collaboration for
Elder Care
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Objectives

Define collaboration and the need for an
interdisciplinary approach to geriatric care.

Describe the types of teams and stages of
team development

Differentiate education and skills among
different professionals on geriatric healthcare
teams
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Objectives
 Define
the principles of successful
teamwork, interdisciplinary
collaboration, and steps in the careplanning process.
 Discuss
the concept of team conflict
and conflict management skills.
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Collaboration is……
 shared
planning, decision-making,
responsibility, and accountability
 Importance
of collaboration:
 Complexity
of chronic and acute problems too
complex be managed by one provider
 Increases likelihood that issues will be
addressed
 Increases coordination of care
 More efficient care delivery
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Types of Teams

Unidisciplinary Team: same discipline
 Multidisciplinary Team: different discipline;
members independently develop plan; fixed
roles; members are consulted about plan of
care; MD assumes leadership
 Interdisciplinary Team: different disciplines;
flexible roles, collaborative, and synergistic;
partners in designing care plan; situational
leadership
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Stage of Team Development

Forming – creation stage; testing group norms;
define boundaries; polite but untrusting;
understanding roles

Storming – confronting stage; friction; jockeying
for position; test out each other

Norming – interdependence; establish norms
and patterns; constructive expression of ideas
and opinions; heading in the right direction

Performing – develop solutions; interests are
shared; will work together
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Education and Overlapping Skills

Team members bring unique sets
of skills from their discipline

The team looks at medical,
psychological, emotional, social,
economic, living conditions, and
nursing issues and interventions
ELEMENTS OF TEAMWORK:
 Coordination of services
 Shared responsibility
 Communication
 Mutual accountability
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Physician, MD
Dietitian
Nurse Practitioner (NP)
Clinical Nurse Specialist
(CNS)
Geriatrician
CAQ
Chaplain
Physical Therapist
(PT)
Physician
Assistant (PAC)
Interdisciplinary
Collaboration
Pharmacist, RPh,
PharmD
Social Worker
LSW, LMSW, ACP
Occupational
Therapist
OT, OTA, COTA
Psychiatrist
Psychologist, PhD
EdD or PsyD
NURSE
(RN, LPN)
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Identify right issue
STRUCTURE
Agenda
Timelines
Roles
Involve the right
stakeholders
Invite
collaborators
from other
disciplines
Negotiate,
articulate
roles; establish
ownership
Principles of
Interdisciplinary
Collaboration
Have a
PLAN OF ACTION
TIMELINES
OUTCOMES
Establish
TEAM RULES
Minimize
competition
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Effective Meetings
Structure
1. Agenda
2. Timeline
3. Roles are defined:
•
•
•
Leader or Facilitator
Timekeeper
Recorder
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Team Rules…stay on target
Attendance and timeliness
Prepare materials ahead of time
Handling disruptions
Contributing to / participating in discussion
Appropriate ways to manage conflict
Acknowledge other professionals’ roles
Share information with respect and cooperation
Confidentiality of team discussions
Agreement that team goals represents all participants’
views
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TRUST
Minimal
Struggles for
power
Members
support each
other
Known and
agreed-upon
purpose, goals
and objectives
Listen to
each other
EFFECTIVE
TEAM
Disagreement without
tyranny
Constructive criticism
without personal attack
Assignments are
clear, accepted
and carried out
Cooperation &
coordination;
decision by
consensus
Clear roles and
responsibilities
Competent,
professional, and
personally effective
Open, sharing,
and honest
communication
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OVERARCHING TEAM GOALS:
Patient’s:
Family’s:
Team’s:
Problem
Expected Outcome
Impact on Health
and Quality of Life
Strengths /
Resources
Plan
(Who/What /When)
Includes gathering
more information
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Activity: Care-Planning
Process
Case Scenario: Ms. J
Questions:
 What team members need to be
involved in this case?
 What are Ms. J’s most important health
issues, and who should be involved in
managing these issues?
 Develop a management plan for Ms. J.
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Team Outcomes

Problems identified and discussed; patient
and family preferences considered

Medication management and lower cost

Focused on critical problems and set
appropriate goals

Social Worker – applying for Medicaid and
community services available

Financially feasible medication plan
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Team Process Evaluation
 Negotiate
team priorities
 Agreed to specific assignments
 Clear roles
 Stay engaged; group input; no SILO
mentality
 Specific disciplines provided expert
opinions
 Follow up plan – Measurable
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Team Conflict Defined…
…competitive or opposing action of
incompatibles; mental struggle;
opposing needs, drives, wishes,
internal and external demands
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When do conflicts occur?
When any team member….

Feels pressure from group to assume a role

Allocated roles are constraining / inhibiting
development

Feels that sanctions imposed to induce him
or her to maintain a role; are not fair /
commensurate

Cannot develop acquired capabilities in
assigned role

Wishes to go beyond definition of role
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Viewpoints on Conflict

Competitive – one must win

Compromising – middle position; all
parties give a little to gain

Collaborative – need of both / all are met

Accommodating – avoidance;
accommodating
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Team Communication
 Actively
 Define
 Ask
listen
the problem
open questions
 Clarify
responses
 Paraphrase
and Reframe
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Conflict Management

Attack the problem, not the person.
 Focus on what can be done
 Encourage different points of view
 Express feelings without blaming
 Accept ownership
 Listen to understand the other person's
point of view
 Respect the other person's point of view.
 Solve the problem while building the
relationship.
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Questions?
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