Understand different ways of working in a team, how to collaborate with other team members and incorporate information from other team members into your own role.
Team types
Three types of rehabilitation teams are often described in the literature.
There is a tendency to use the terms interchangeably, but there are important differences between them.
Multidisciplinary team
Tends to see services delivered as independent silos using the clinical expertise of each discipline.
Interdisciplinary team
Emphasises an integrated approach to goal setting and care planning.1
Transdisciplinary team
Each team member becomes sufficiently familiar with the roles and approaches of other team members that the disciplinary boundaries blur.
Multidisciplinary
Features
- The team working with the person and their family is made up of a range of professions, all of whom work on goals and steps specific to their area of expertise.
- Team members may document discipline-specific rehabilitation plans with goals or steps to achieving the person’s impairment-level and/or activity-level priorities. These may, or may not, be linked to broader aspirational or generic goals.
- Clinicians work independently but recognise and value contributions from other team members. They may collaborate through case conferencing or team meetings.
- The role of each team member is defined in line with their professional role.
- Clinicians provide separate evaluations and progress reporting.
- Clinicians set goals that are specific to their discipline and implement individual intervention plans.
Challenges
- Need to ensure adequate team collaboration to avoid disciplinary silos impeding efforts toward shared outcomes.
- Individual therapies may not take into account other influences on performance.
- There is a burden of therapy if actions and interventions are not coordinated and rostered across the team.
- There is a risk of multiple clinicians delivering similar intervention.
- Client experience may be repetitive as history and story, goals, fears and priorities are all discussed with each team member.
- Different team members may prioritise different goals.
Interdisciplinary
Features
- Team members collaborate in the evaluation, assessment and development of the intervention plan.
- Everyone is working towards the common goals.
- Frequently planning and coordination is managed by a nominated coordinator or case manager. The coordinator either comes from within the team or is an additional team member. They are the primary point of contact for the person and their family.
- Everyone uses knowledge and expertise from other team members to add value to their own approach.
- Each discipline contributes to progress reporting against the shared rehabilitation plan.
Challenges
- Professional boundaries may become blurred and it may be perceived that there is questioning of professional judgement or imbalance in power.
Transdisciplinary
Features
- Team members provide joint evaluations and work together to develop goals and carry out interventions.
- One team member will usually be the person that the patient’s family interacts with. They will provide the intervention, but may consult with other clinicians to do so.
- Works best when goals are largely participation-based and do not require specialist skills of a single discipline to achieve.
Challenges
- Disciplinary lines are blurred.
- Team members share role functions to a high degree.
- Reduction of specialisation.
- Can lead to burn-out of the clinician if the complexity of the person’s needs would be better served by an interdisciplinary approach.
References
- Nancarrow S, Booth A, Ariss S, et al. Ten principles of good interdisciplinary team work. Hum Resour Health. 2013;11:19. DOI:10.1186/1478-4491-11-19