Interprofessional Healthcare and Communication Flashcards
What kind of teams are found in Healthcare?
- Whether the patient is in an in-patient hospital or residential facility
- Whether the patient is been seen in the community
- If they are in the Private or Public system
- What conditions/illness are being managed (acute, chronic etc.)
- What health practitioners are on the team
Models of Collaborative Team Practice
Multi disciplinary
Inter disciplinary
Trans disciplinary
Multidisciplinary Teams
Example of Health Professionals
Dr = GP
PT = Physiotherapist
OT = Occupational Therapist
SP = Speech Pathologist
Psych = Psychologist
Nurse = Nurse Practitioner
Pharm = Pharmacist
SW = Social Worker
Multidisciplinary Teams – how they work
Different professions/disciplines caring for same person/patient
Work independently
Develop individual goals and plans
Maintain professional boundaries
Limited communication
Multidisciplinary Teams – what happens
- Gatekeeper (conduit of information and referrals) may be the GP
- Communication between professionals is minimal and usually formal (such as referral letters and responses, discharge and treatment summaries)
- Each practitioner interacts with the person/family, but not necessarily with other the practitioners involved
Multidisciplinary Teams - issues
Client/Patient/Carers may have to function as a Case Manager
Repetition of information and data collection (e.g. client assessment)
Informing practitioners of the goals and plans of other practitioners
Conflicting or varying goals and plans can be confusing for client/consumer
Time and resource consuming (travel, cost, time)
Interdisciplinary Teams - function
- The team functions as an integrated group
- Collaborate to create goals and plan, coordinate, manage and monitor care
- Roles and relationships are managed through:
- Appropriate leadership
- Respect and trust
- Person centred approach to care
Interdisciplinary teams -
function cont.
Communication occurs frequently and is essential to ongoing work of the team
* Formal and informal team meetings and face-to-face
communication
* Shared information and records
Shared and supported decision making
Transdisciplinary Teams
Roles of individual team members blurred
* Team members take on roles of other
professionals in the team – requires upskilling & training
* Encourages exchange of information, knowledge and skills
Transdisciplinary Teams cont.
Overcomes many of the limitations of multidisciplinary & interdisciplinary teams
* Reduced fragmentation of services
* Less confusion for client and family/carer
* Less conflicting reports from different health professionals in the team
* Improved coordination of services
Why is communication important in healthcare?
Patient/person safety is the number one issue
Patient/person/family satisfaction
Health professional safety
Health Professional and team satisfaction
What is an Adverse Outcome/Hospital Acquired Complication?
Unintended harm to patient because of healthcare and services provided
* In recent years it is estimated that 5.3 – 9.2% of patients experience adverse events.
* Ranasinghe et al. (2020) suggests this costs the Australian HealthCare System >$60 billion
* It has been suggested that 70% of adverse events due to problems in communication
What can go wrong
- Wrong surgery (wrong site, wrong patient, wrong procedure)
- Retained foreign body left at surgery
- Blood or transplant organ incompatibility
- Administering incorrect medication or dosage
- In-hospital trauma (falls, burns)
- Hospital acquired (nosocomial) infection
Causes of communication errors
Multifactorial
* An overlap of human and system errors
Human errors
- Knowledge-based
- skill-based
- resulting from a failure to follow rules
- fatigue-based
- an inability to cope with the complexities or demands of the
healthcare system.
Systems/organisation failures
- Poor management decisions
- dysfunctional organisational/team cultures
- poor communication protocols
- inadequate resources
- Inadequate staffing
- poor documentation procedures
- a lack of safeguards and check points
Communication between health practitioners face-to-face/verbal/real time
- Informal
- Discussions during care
- Formal
- Handover/ISBAR
- Team Meetings/Case conferences
What is “handover”?
The effective transfer of professional responsibility and accountability for some or all aspects of care for a patient/s to another person or professional group. (ACSQHC)
* Cases of clinical deterioration
* Transfers to another ward/area
* Between shifts/personnel
* In collaborative team meetings/handover
* Transfer to another hospital/facility
* Discharge
Why handover is important
All relevant information is included
Information is provided in a recognizable and appropriate sequence
If written, it provides an accessible and permanent record
If face-to-face enables opportunity for questions and clarification
If in the presence of patient/person/carers/family they can be included
The ISBAR Protocol
I – Identify
S – Situation
B – Background
A – Assessment
R - Recommendation
Written documentation
Legal documentation used to record and share health information
What is Health Information?
- any physical, mental or psychological information about a person
- a person’s disability
- a person’s expressed wishes regarding future provisions of health services
- health services that have been, or are to be provided to a person
- other personal information collected to provide, or in providing, a health service
- personal information collected in connection with a donation, or intended donation of a person’s body parts, organs or body
substances - genetic information that is predictive of a person’s genetic status
Who are Health Care Providers?
- Assess, maintain or improve an individual’s health
- Diagnose and treat illness, injury or disability
- Provide disability, child, aged or palliative care services
(including physical and intellectual disability services, nursing
homes, hostels) - Dispense medication on prescription
Health Records - formats
Hardcopy: Still routinely used
Electronic (within practice/institution):
* Private practitioners
* Health Institutions/Facilities/Organisations
(usually central and shared within the institution)
Shared Electronic: Personally Controlled Electronic Health Record (PCEHR)
