Interdisciplinary Collaboration for Elder Care

1. Interdisciplinary Collaboration for Elder Care

2. 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

3. Objectives • Define the principles of successful teamwork, interdisciplinary collaboration, and steps in the care-planning process. • Discuss the concept of team conflict and conflict management skills.

4. 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

5. 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

6. 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

7. 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

8. Interdisciplinary Collaboration

10. Effective Meetings Structure • Agenda • Timeline • Roles are defined: • Leader or Facilitator • Timekeeper • Recorder

11. 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

13. OVERARCHING TEAM GOALS: Patient’s: Family’s: Team’s:

14. 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.

15. 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

16. 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

17. Team Conflict Defined… …competitive or opposing action of incompatibles; mental struggle; opposing needs, drives, wishes, internal and external demands

18. 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

19. 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

20. Team Communication • Actively listen • Define the problem • Ask open questions • Clarify responses • Paraphrase and Reframe

21. 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.

22. Questions?