Interprofessional Collaborative Care Flashcards
1
Q
Benefits of team-based care delivery
A
- Improved quality and quantity of services
- Improved accessibility
- Improved job satisfaction for HCPs
- No one care provider can meet all needs associated with illness and bereavement
- Maximal diversity of professional expertise
- Reduced hospitalization time and costs
- Reduced unanticipated admissions
- Better accessibility
2
Q
Domains of care associated with illness and bereavement
A
- Physical
- Disease management (e.g. investigations and management, treatment decisions, team collaboration)
- Pain and other symptoms
- Function
- Nutrition habits
- Physical activity
- Cognitive function - Social/Cultural
- Finances
- Relationships (e.g. estrangement)
- Personal routines
- Recreation
- Vocation (e.g. loss of role)
- Rituals
- Legal issues
- Family caregiver support (e.g. family stress/fatigue)
- Practical issues - Psychological
- Personality
- Psychological symptoms
- Emotions (e.g. fear of progression, helplessness)
- Control and dignity (e.g. helplessness, loss of control)
- Coping responses (e.g. feeling a victim)
- Self image/self esteem
- Loss and grief - Spiritual
- Meaning and values (e.g. search for meaning)
- Existential issues (e.g. helplessness)
- Beliefs
- Spirituality
- Rites and icons
- Loss and grief
- Life transitions
- Religions
3
Q
Domains of care: Physical
A
Physical
- Disease management (e.g. investigations and management, treatment decisions, team collaboration)
- Pain and other symptoms
- Function
- Nutrition habits
- Physical activity
- Cognitive function
4
Q
Domains of care: Emotional/Psychological
A
Psychological
- Personality
- Psychological symptoms
- Emotions (e.g. fear of progression, helplessness)
- Control and dignity (e.g. helplessness, loss of control)
- Coping responses (e.g. feeling a victim)
- Self image/self esteem
- Loss and grief
5
Q
Domains of care: Social/Cultural
A
Social/Cultural
- Finances
- Relationships (e.g. estrangement)
- Personal routines
- Recreation
- Vocation (e.g. loss of role)
- Rituals
- Legal issues
- Family caregiver support (e.g. family stress/fatigue)
- Practical issues
6
Q
Domains of Care: Spiritual
A
Spiritual
- Meaning and values (e.g. search for meaning)
- Existential issues (e.g. helplessness)
- Beliefs
- Spirituality
- Rites and icons
- Loss and grief
- Life transitions
- Religions
7
Q
Definition: Multidisciplinary/professional teams
A
- Two or more care providers from different professions or disciplines within the same profession
- Each assess the patient and work with the patient (and family) to achieve the goal
- Cooperate and coordinate with one another
- Simple difference of different professional backgrounds
Primary goal:
- Coordinate the care strategies of a profession or discipline while each stays committed to their own profession
8
Q
Definition: Interdisciplinary/professional teams
A
- Care providers from different disciplines or professions, the patient, and/or the family
- Exchange knowledge and expertise and integrate the strategies learned from one another to achieve common goals
- Common decision-making process, all team members have a defined place in the care regimen
Primary goal:
- Continual communication, shared decision making with consensus, and shared expertise
9
Q
Stages of team development
A
- Forming
- Team formation, insecurity and testing - Storming
- Conflicts arise, self-oriented behaviour emerges, role confusion can be an issue
- Conflict management and skills to enhance team function are important - Norming
- Greater team cohesiveness as members learn to balance their processes and tasks using collaboration competencies - Performing
- Innovative energy, leadership shared between team members depending on the needs of each situation - Adjourning
- As team members leave and are replaced, the whole team process may revert to earlier stages
10
Q
Canadian Interprofessional Health Collaborative (CIHC) Competencies for Interprofessional Collaborative Practice
A
- Role clarification
- Team functioning
- Patient/client/community centered care
- Collaborative leadership
- Interprofessional communication
- Interprofessional conflict resolution
11
Q
CanMEDS roles relevant to teamwork
A
- Communicator
- Collaborator
12
Q
Why might teamwork be important to Palliative care?
A
- Multiple resources provide opportunities for creative solutions to complex needs
- Responsibility shared within the team (less caregiver stress and burnout)
- Greater likelihood that all patient/family needs will be identified and addressed
- Enhanced opportunity and support for ongoing communication between team members
- More seamless, consistent care delivery experiences for patients and their families
- Greater understanding of and respect for the unique skills and perspectives of various disciplines/professions
- Greater job satisfaction and improved staff retention due to feeling heard, valued, and included
13
Q
Situation awareness - defition
A
- Respect one another’s competencies, assess the needs of each health situation, and determine the complexity of the team and the demands on each member (including patient and family)
Each team member in an interdisciplinary collaborative team should demonstrate situation awareness - assess the situation, seek appropriate input from one another, and knowing when and with whom to share decision making
14
Q
How to optimize team communication and collaboration
A
- May be facilitated through technology (teleconferencing, shared access to patient charts)
- Be wary of time constraints and level of detail of information shared (may be insufficient)
- Virtual teams may have limited time, no clear leadership, and few opportunities to work together
15
Q
Evidence that an interprofessional collaborative care team is not working well together
A
- Focus moves from needs of patient and family
- Loss of common vision or goals
- Reduced quality of care (e.g. ER presentations, etc.)
16
Q
Concept of total pain
A
- Encompasses difficulties in all four domains of issues associated with palliative care
- Physical
- Emotional/psychological
- Social/cultural
- Spiritual
17
Q
Three philosophies of teamwork
A
- Directive philosophy
- Assumption of hierarchy within the team
- One person takes lead by virtue of status/power and directs others - Integrative philosophy
- Assumes each professional’s contribuation has equal value
- All team members are team players
- Communication within the team are vital - Elective philosophy
- Clear and distinct team roles to operate autonomously
- Relate briefly to other team members when seen as a need
18
Q
Members of the palliative care team
A
Core team
- Physician (with admin support)
- Specialist nurse
Extended team
- Psychology
- Social work
- Chaplain
- PT
- OT
- Dietician
- Specialist pain management
- Patient
- Family members
19
Q
Miller’s Pyramid (Model of assessment)
A
- Knows
- Multiple Choice questions - Knows how
- Extended matching questions
- Portfolio - Shows how
- OSCE
- Stimulated patient assessment - Does
- Multisource feedback
- Direct observation of procedural skills
- Mini CEX
20
Q
Benefits of certification in hospice/PC nursing
A
Individual nurse has:
- Proven and tested competency across a spectrum of palliative care and hospice nursing care
- Access to a national network of experienced/knowledgeable palliative care and hospice nurses
- Demonstrated commitment to his/her specialty practice
- Dedication to professional development
- Asset to employer given focus upon quality in healthcare
