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44693Downloads1 I Published: 20 Nov ,2017
Integrated or collaborative practice is a partnership between a team of health providers and also client in a participatory coordinated and collaborative approach that is aimed at shared decision making emphasizing on issues of health and social care (Andrews and Read, 2009). It is a process that includes decision making through communication thus enabling a synergistic influence of knowledge and skills of the group. There are various elements of collaborative practice that consist of accountability, coordination, responsibility along with cooperation and mutual respect and trust (Williams, 2012). It is the collaborative practice for blending professional cultures which can be achieved through sharing of skills and thus improving the quality of patient care.
In the present report, emphasis will be laid on integrated or collaborative care from the context of physiotherapy. This will include understanding of current theories and practices models of integrated team work in health and social care and their impact on practice. This will also include appraisal of published research that provides evidence based practice and will also reflect upon learning and experiences of collaboration and its influence on the practice. This is followed by development of skills, knowledge and dispositions of leadership such that it facilitates innovation and foster collaborative working.
Here, the context is that I am a senior physiotherapist working in XYZ hospital, United Kingdom. I have been working at various places and there I used to work with a team of professionals who belong to various training backgrounds. There, my learning increase to a significant level that helps me to learn with team and members of varying backgrounds as I learn to develop collaboration and coordination with them. All this has helped me to reach at such a position and now as a senior physiotherapist I am working as a leader of various inter professional teams that provide services to the patients.
Inter professional or collaborative practice is a key factor in initiatives that are designed with the aim of increasing the effectiveness of health services that are being offered to the public. The concept of inter professional teams in health and social care include that it is a unique form of team which involves significant collaboration among the members and breaking down of boundaries (McMurray, 2006). As per the reports released by World Health Organization, a health system can be defined as one whose purpose is to promote, restore as well as maintain the health followed by well being of people.
As per the policy framework of WHO, Collaborative practice can be considered as a means to a promising area to strengthen the overall system of healthcare s as to bring an improvement in outcomes. It is required so as to meet the complex needs related to healthcare taken into consideration the presence of limited human and financial resources. In this regard, many nations in WHO European Region have tried to attain an overall integration of the hospital systems. All the strategies related to this framework are based on overall aim to improve the coordination followed by integration of services. The aim of all the strategies is to develop multi-professional teams in the area of primary, secondary as well as tertiary care (Karim and Ross, 2008). It is only by integrating of the strategies an overall improvement can be brought in the services. These are most likely to affect my area of integrated practice while I am working in hospital by making me focus on reducing costs followed by provision of quality services and overall satisfaction to users.
By following an integrated care approach for the patients and working in teams having inter - professionals from varying backgrounds my own work of practice has been influenced to a significant extent. In this respect, it is evaluated that owing to the technological advancements people are becoming more and more aware of the various physiotherapy services that are available to them and on this basis they are acknowledging their rights and also demanding for new, advanced and better services (Goh, Chan and Kuziemsky, 2013). Owing to the prevailing situations, practitioners now also require to adhere to the latest technological equipments that can be used for treating the patients in the best possible manner. By working in teams of inter professionals and adopting an integrated care approach has forced all practitioners to work together and learn and raise their awareness related to the new advanced technology useful for them. Working as a team has helped me in my own area of practice as this has led to increment in my learning related to various new technological aspects that can be included in the physiotherapy practice. With this, I can give the best of treatment to my patients and satisfy them. In addition to this, the developments in information and communication as well as medical technologies have a major impact on the quality of integrated care to be implemented at primary health care and hospitals. This has also offered new opportunities of learning for the professionals in the integrated care teams and thus has also affected my area of practice. By working with team of practitioners belonging to various backgrounds I came to know about different problems that people suffer from and the way in which applications of physiotherapy can be applied to solve them.
Integration of multi professional teams working on the patients has also influenced my practice area as with this I have now become more capable of planning of services regarding treatment to be given to the patients in a better and a fruitful manner. With this, my span of knowledge has also increased regarding other types of treatments apart from medical that can be imparted to the clients suffering from different medical conditions. In addition to this, work with professionals and following an integrated care approach has helped me in understanding the ways of establishing a proper interaction with my clients and thus get to know their needs and preferences (Karim and Ross, 2008). With understanding of this aspect I was able to bring improvement in my own area of practice as I now became capable in knowing the way in which my patients want to be treated.
Applying an integrated care approach and working with professionals has help in refining my own practice as I learned the various best possible ways that can be applied by practitioners. As a physiotherapist I now became more capable of working with more of perfection and appropriateness. This I did by showing a positive attitude and kind behaviour towards my patient so that they felt satisfied in taking services from me.
Professionalism in nursing practice is the commitment of nursing staff towards caring and showing compassion of strong ethical values, continuous development of self and others along with responsibility and accountability for insightful practice as well as demonstration of flexibility and collaboration among one another (Zwarenstein, Reeves and Perrier, 2005). It can be evaluated that it is the professionalism in nurses in physiotherapy that embraces a set of values and attributes which are expected from them to whom society has extended the privilege of considering and naming them as professionals. Professionalism in physiotherapy among nurses has a considerable impact on collaborative practices as well as team work (Morrison, 2007). This is so as core values of being professional and having a professional identity includes being honest and having integrity on their part and understanding of their responsibilities as well as supporting one another in the team (Roa, 2003). Professional nurses provide care by collaborating with the patients as well as their colleagues and seniors bring out the practice of effective team work and integration.
However, it can be critically evaluated that nurses practicing physiotherapy have the responsibility of supporting professionalism by fulfilling their responsibilities and having involved in team work and collaborative practices (Karim and Ross, 2008). But, they support this aspect of professionalism if they have a professional identity as well as having the autonomy of making decisions within their scope of practice of physiotherapy. This also includes their freedom to having a word in decision making for the organization they are working with and also when practice is based upon some kind of evidence (Barr and et.al., 2005).
It can also be said that professionalism has a professional identity in physiotherapy has a positive impact on collaborative practices as well as team work. This is because professionals have a sound theoretical knowledge of their values as well as roles and accountabilities and also understand the importance of team work and working in collaboration with one another (Andrews and Read, 2009). By making them aware of various policies and practices they are made aware of responsibilities of the professional identity regarding practice of team work and thus they use this knowledge in practice also (Lumague and et.al., 2008). In addition to this, having a professional identity eventually makes the professionals to demonstrate a strong commitment to working with one another in teams. This is depicted by them through respecting each other’s knowledge and views regarding care to be given to the patient (Tanco and et.al., 2011). With this, it can also be said that having a professional identity in physiotherapy favours the practice of team work and collaboration as professionalism includes being open minded and having a desire to explore new knowledge (Bridges and et.al., 2011). Thus, this value promotes team work by working in teams with various professionals from same field as well as from varying backgrounds and increasing their knowledge.
It is further a known fact that physiotherapy requires a unique blend of learning related to scientific, therapeutic and interpersonal areas. While working in varied kinds of physiotherapy departments, I have learnt that a key role is played by every physiotherapist for shaping up the dynamic as well as evolving nature of profession (Williams, 2012). It is practices that are undertaken on part of individual physiotherapist helps to shape up career in working and personal lives (Atwal and Caldwell, 2005). This further puts a crucial impact on perception held by others towards professionalism in physiotherapy. As per my observation by being a part of physiotherapy profession, I have found out that physiotherapists are required to work within regulatory framework so as to adhere with area of professionalism. In the similar manner, for maintaining professionalism it is required to adhere with moral as well as ethical code of conduct within the working environment of physiotherapy (Goh, Chan and Kuziemsky, 2013). Professionalism in this profession further entails for Demonstrating autonomous practice followed by making the members of physiotherapy department becoming aware about the individual limitations that is possessed by them.
Professional identity can be defined as a set of those attitudes, beliefs, experiences, ideals as well as the principles that define a person in the overall physiotherapy career. It has further been used to define the persons with whom interaction take place in the professional lives. It is the existence of these interactions as well as professional experiences that are there to define the overall professional identity (Adams and et.al., 2006). In this regard, for ensuring effective teamwork within profession of physiotherapy the concern of Professional identity is towards adhering for group interactions in workplace so that the members of department are able to compare as well as differentiate themselves (Adams, 2004). Hence, the need as part of Professional identity is to adhere towards a set of attitudes, values, knowledge, beliefs and skills in the area of physiotherapy setting that should be taken by professionals (Ajjawi and Higgs, 2008). Then only there can be an assurance towards collaborative practice and effective teamwork.
The concept of professional identity is most likely to help in building of relationship values so that different team roles can be performed in the most effective manner. This will aid in enhancing the overall patient as well as population centered care which is safe, timely, effective as well as equitable in nature (Callaghan, 2006). It is only by keeping a proper professional identity in terms of a proper attitude to the colleagues and other health care professionals there is likely to be a creation of team work that will favor over work culture followed by provision of best faculties to the clients (Valsecchi and et.al., 2012). For example, keeping a positive attitude in times of hardships or heavy work load may aid in motivating the entire staff members so that they work to the best of their abilities. The patients coming for physiotherapy sessions are likely to be benefitted by the positive approach being followed by the physiotherapists (Andrews and Read, 2009). In the same way, showing a good belief towards overall well being of patients and encouraging the clients in the area of progress is likely to aid in easier as well as faster recovery. In the same way, as a physiotherapist I have handled a large number of patients which has aided in providing varied kinds of experience about collaborative practice and effective teamwork (Zwarenstein, Reeves and Perrier, 2005). Hence, these experiences are likely to aid me towards bringing an overall improvement in the practices that are related to work.
Leader can be defined as a person that has got a dominant position in any given field. They are the ones who are able to exercise an increased degree of control as well as influence on other members (Williams, 2012). In this regard, there is a presence of varied kinds of leaders. An autocrat has least amount of confidence in people followed by a general feeling of distrust. Decision making power runs in the hands of autocrat (Johnson, 2014). Benevolent Autocrat is the one that portrays him as a superior figure, makes all decision followed by convincing the subordinates to work as per him. Consultative Democrat showcases a presence of confidence and trust in people followed by carrying out a thorough communication (Loiseau, 2014). Participatory Democrat instils confidence and trust in employees where all major decisions are taken by discussions. Laissez-faire leader is detached from the people whom are to be served by him.
An effective form of leadership does have a crucial impact on collaborative practice as well as ensuring towards effective team work. This is also true for the area of physiotherapy. In this regard, the physiotherapist is required to have a good knowledge about group dynamics followed by a presence of good communication so as to illustrate a presence of collaborative practice and effective team work (Forsyth, 2006). There will be a depiction of effective leadership skills only when the physiotherapist has awareness when a delusional material is being introduced in a group discussion. In this regard, there is a requirement to initiate towards appropriate measures so that focus of group can be maintained (Andrews and Read, 2009).
In this regard, there is a presence of varied kinds of leadership styles. In Laissez-Faire leadership, there is an absence of supervision of employees followed by a feedback mechanism. It is best suitable for those employees who are trained and have high level of experience. In autocratic leadership style managers do not take input of team members and impose autocracy on them thereby leading to a close supervision (TYPES OF LEADERSHIP STYLES, 2014). Democratic leadership style values the inputs given by team members and peers followed by boosting up employee morale. Transactional leadership style sets predetermined goals for employees who are then reviewed by mangers. Corrective action is taken in form of training or correcting employees followed by rewards in form of bonuses (Mail, Mohamed and Atan, 2006).
There has been a usage of mixture of leadership style while working as physiotherapist for many reputed firms. However, the major emphasis given by me was on democratic leadership style. Here, I took crucial inputs from my team members as well as peers. But I made sure to carry out final decision making (Zwarenstein, Reeves and Perrier, 2005). With the help of this leadership style, I have tried to boost up the morale of other physiotherapists and nurses who worked under me. This was majorly done by involving them in the decisions that were of concern to their overall working (Ford, 2005). I benefitted on account of this leadership style when there was a need to introduce changes. These were related to installing new technology to treat the clients, promising of sessions to new recruits among others (McMurray, 2006). The team members supported me whenever any change was introduced thereby making the challenging times easier to be dealt with. Other than this, I ensured to adhere towards varied style of leadership behaviour as per the changing requirement (Zwarenstein, Reeves and Perrier, 2005). I paid a due attention on following all kinds of leadership styles as and when the need arose. For example, in case of in group ensured to adhere towards participatory as well as democratic style of leadership (Holt, Self, Thal and Lo, 2003). Whenever there was a huge inflow of patients or important surgeries were assigned then autocratic style of leadership was followed by me. In order to collaboratively work with other professionals I made communication as a major aspect while work is being carried out in a group setting (Williams, 2012). Here, the requirement is that leader should possess a substantial level of communication skills so as to address the quality of a group leader. While handling my entire physiotherapy department, I faced many difficulties in the area of communication (Bridges and et.al., 2011). This happened on account of presence of a large group size, strong personalities as well as existing differences in opinion (Andrews and Read, 2009). I also found out that some of the well qualified as well as experienced physiotherapy professionals dominated the entire conversation. This created a situation of conflict and even cold war’s. Here, I ensured to use communication so as to resolve conflicts (Johnson, 2014). While organising meeting before handling critically ill patient in need of a surgery, I held meetings and ensured that everyone got a chance to express their view points. I also carried out bonding sessions which also involved patient, there family members as well as the healthcare professionals of my team. These were in form of ice-breaking games, pod lunch, or fun outing (Pardey, 2007). However, more issues were faced when the number of recruits in form of dieticians as well as junior doctors, physiotherapists and nurses started joining the physiotherapy ward. Communication was not feasible in such a huge team. Hence, for ensuring towards a smooth flow of communication in such a huge group setting I made usage of technology. These were in form of email, Google Groups as well as Facebook (Bianco and Schermerhorn, 2006).
Group dynamics can be defined as those interactions which have an influence on overall attitude and behaviour of people when they are grouped with others. This may happen by choice or during accidental circumstances. It plays a key role in the healthcare related profession of physiotherapy where individuals are treated for a specific disorder (Van Vugt and Schaller, 2008). The members of group in this context will be inclusive of nurses, care workers, physiotherapist that must maintain a team dynamics so as to work in collaboration with each other. Here, the group dynamics will only work when there is an intake of collaborative decision making (Groves, 2006). It is only when physiotherapist and other working staff will show a positive dynamics within team there can be a development of mutual trust, respect as well as effective working so as to work towards welfare of patients (Zwarenstein, Reeves and Perrier, 2005). However, while working as a physiotherapist in many hospitals there has been a presence of many instances when the lack of proper team dynamics on part of Group leaders and team members there was a creation of a negative group dynamic (Hackman, 2002). Once, I observed that there was a lack of well defined authorities in a hospital. This led to dominant doctors to have a control over entire team working in physiotherapy department. It was on account of a lack in direction, infighting that there was a mismatch towards achievement of priorities (Andrews and Read, 2009). Once, I also observed a free riding attitude in some of the team members. These were inclusive of some doctors as well as senior nurses (Aronson, 2008). They took the work of treating the patients as an easy one and left it all to be accomplished by junior healthcare professionals. Hence, it put a limit towards the overall contribution that could have led to a well defined care for patients (Mail, Mohamed and Atan, 2006). In the same way, a few new recruits in physiotherapy ward were black in origin and hence they had to face a presence of negative team members' perceptions. They were often judged in a harsh manner by other colleagues (Forsyth, 2006). Hence, they developed a tendency to hold back the opinion even during group working while undertaking a treatment of seriously ill patient.
In this regard, in order to negate such difficulties the requirement I ensured to adhere with Tuckman’s theory of group dynamics when I was appointed at the post of senior physiotherapist. It explains that as there is an establishment of maturity, ability as well as relationships in teams, the leadership style also undergoes a big change (Johnson, 2014). The leaders begin with a style of directing followed by moving towards coaching, participating as well as delegation (Zwarenstein, Reeves and Perrier, 2005).
Forming – At this stage, there is a high dependence on leaders for guiding as well as provision of direction. Hence, I assigned myself as a leader while work was being carried out in a physiotherapy department (Williams, 2012). I churned my leadership as well as technical skills related to physiotherapy so as to have an easy control over other team members. I also ensured to answer questions that are related to purpose of working so as to achieve the norms of integrated care for patients.
Storming – This stage shows its effect when a decision is to be taken from entire team as to how they are required to provide proper care to patients. There was an increased tendency on part of senior health care professionals to start vexing for position (Van Vugt and Schaller, 2008). Hence, I started receiving challenges from team members while patients were being provided with interprofessional care. Hence, the requirement on my part as a leader was to make the team members get aware about the basic goal which is of caring for the patients (Loiseau, 2014). I further conveyed to my entire inter professional team there should be a presence of least amount of distraction from relationships and emotional issues and focus should be provision of quality care to patients who come to hospital for physiotherapy related treatment.
Norming – This stage happens when there is a formulation of Agreement and consensus among team members if they respond well towards the facilitation that has been offered by the leader. In this, big decisions related to handling a tough patient was taken by group agreement (Mail, Mohamed and Atan, 2006). In the same way, decisions related to daily activity schedule for patient in form of Electrotherapy and Hydrotherapy, fixing the diet chart etc was taken by individuals inclusive of middle level physiotherapist, nurses and dietician. It further entailed for ensuring towards Commitment and unity (Forsyth, 2006). It further led to creation of a general respect towards leader followed by sharing of leadership by team thereby lording to absence of grudges on part of senior healthcare professionals (Andrews and Read, 2009).
Performing – At this stage, any team depicts a presence of strategic awareness. It also knows what activities are being performed and why. While working as senior physiotherapy and also as a team leader, I noticed the presence of shared vision by the team members at this stage (Andrews and Read, 2009). I ensured that the leaders stood on their own feet without the interference from me. There was also a presence of an increased form of team autonomy hence an effective delivery of results (Johnson, 2014). A collaborative working was also observed on part of team members. The members did ask for my assistance during the time of personal as well as professional development.
Other than this, there is also a presence of Leader-Member Exchange Theory in relation to group dynamics that can be applied in the area of physiotherapy. It gives a key emphasis on relationship that has been found to develop between managers as well as members of team (Mail, Mohamed and Atan, 2006). All kind of relationship that exists between managers and subordinates has to pass through three basic stages. These are inclusive of Role-Taking, Role-Making and Routinization (Zwarenstein, Reeves and Perrier, 2005). Same can be applied in the area of physiotherapy as well.
Role taking – It occurred when a few healthcare professionals joined the physiotherapy department of which I was the in charge. I tried to utilize my time towards assessing skills as well as abilities possessed by new members (McMurray, 2006).
Role-Making – In this stage, I gave an opportunity to the new healthcare professionals in form of junior physiotherapist to start assisting the seniors so that they feel a part of team (Barr and et.al., 2005). At this stage, it was expected by me as leader of physiotherapy team that new members work hard, act loyally as well as trustworthy when they are at the stage of getting used to the assigned roles as a part of team. I also made sure to sort the new team members into two main groups (Johnson, 2014). I placed those members in the in group who provided there loyalty, trust and were highly skilled. I ensured to gave these physiotherapist as well as junior nurses the maximum attention, provided them with challenges in form of Manual treatments including mobilisations and manipulations (Williams, 2012). I also conducted special training and advancement sessions for them so as to help them grow. However, some of the new recruits inclusive of junior nurses and physiotherapists were somewhere found to be less competent and unmotivated (Loiseau, 2014). Hence, they were made a part of Out-Group. I made their work a bit restricted and unchallenging as they would not worked even if a challenging opportunity would have been provided to them.
Routinization – It is the stage, where there is an establishment of routine between team members and managers. At this stage, being a part of management I ensured that team members give their hard work so as to maintain good opinion of managers by bestowing trust, respect, empathy as well as patience. However, I started facing the brunt of Out-Group members who started distrusting me (Mail, Mohamed and Atan, 2006). I somewhere lagged behind in bringing improvement in these group members on account of the perception that I had developed for them. Hence, I ensured to provide them with mentoring as well as coaching for their professional development and churning of existing skills (Johnson, 2014).
While working in diverse kinds of physiotherapy departments as well as a leading a physiotherapist ward in a hospital a huge developments have occurred in my thinking related to interprofessional/collaborative practice (Andrews and Read, 2009). Being a part of physiotherapy team I was required to work with many professionals. These were inclusive of male or female physiotherapist, student physiotherapist, and physiotherapy assistant practitioner. In large hospital settings, I also got a chance to work with other health professionals (McMurray, 2006). They were in form of medical consultants, nurses, occupational therapists as well as members of orthotic department. Huge developments have taken place in my thinking as a result of working in collocation with such a diversified staff member (Zwarenstein, Reeves and Perrier, 2005).
Earlier I used to face a lot of difficulties while collaborating with work practices of different team members. There was a presence of many conflicting situations with the members (Andrews and Read, 2009). But with the passage of time, I learnt the act of working in teams and started keeping welfare and provision of integrated care to patient as a top priority. Regarding the practice of integrated or inter professional working in health care related especially to physiotherapy there are certain models that have an influence on my practice also (Zwarenstein, Reeves and Perrier, 2005). These are described as follows –
Improving collaboration between separate providers
In this model, health care providers practice separately and have separated administrative structures as well as systems of reimbursements. A number of common strategies are used while implementing this practice model (Anderson, Barbara and Feldman 2007). Care managers may be assigned to coordinate health care for patients who require physiotherapy having complex issues. A health agency may offer physiotherapeutic consultation through telephone to one or more primary care practices that serve patients having complex medical issues (Loiseau, 2014). Practices of information sharing may be formalized such as adopting forms to share basic information. Hence, as a part of physiotherapy team, I have utilized the common strategies in my practice. I have focussed on maintaining an overall coordination between my Care managers, health agency among others (Stille and et.al., 2005). This improved collaboration has aided towards creation of quality care to my patients.
The implementation considerations of this model are that there are significant cultural barriers in this. Most of the primary care providers have not developed the same relationships with community physiotherapy health care providers as they have speciality in that (Audet, Davis and Schoenbaum, 2006). Efforts need to be made to develop such relationships with which providers can agree on strategies of care management and communication with them (Williams, 2012). Primary care providers often have limited knowledge about community agencies through which valuable information can be known. Their willingness to invest time in coordinating care will be influenced by their past ability to have communication that provides physiotherapy services (Christakis and et.al., 2003).
According to this model, physiotherapist who is non physician can provide care to stable patients and physician can give care to critical patient. This model is characterized by independent health care practitioners especially the physiotherapists working in a common setting (Bridges and et.al., 2011). Thus, while working within this model, I have ensured that each individual performs his or her job of physiotherapy within the defined scope of practice (Morrison and Clift, 2006). This practice of parallel model does not have much impact on practice as every individual performs on its own and no one interferes in their work. This model does not involve much of the team work (Honts and et.al., 2012).
In this model of team work in health and social care expert advice is given from one professional in physiotherapy to another one and then through consultative thinking care to be given is decided (Novicevic and et.al., 2003). Consultation has happened in my work practice through direct communication between them and also through letter or referral note. The impact of this model on practice is that since care is given to patient by joint consultation of two professionals’ expert in the field of physiotherapy (Berlin, Carlström and Sandberg, 2012).
This is one of the latest models of team work for practice in health and social care as here practitioners who practice independently from each other now share information regarding a particular patient who require physiotherapy care and who has been treated by various physiotherapists (Andres, 2013). All the providers of health care collaborate to provide safe and high quality care to the patient. I have utilized the concept of collaboration as a model of team work that entails for joint communication resulting in decision making with aim of reaching satisfaction of service users (Andrews and Read, 2009). The basis of this model is that superior quality of patient care can be achieved by contribution of all the service providers. I have further ensured to include a common group of patients and goals for patient outcomes including a shared commitment (Leinonen and Bluemink, 2008). Accordingly, there are certain values that facilitate the implementation of collaborative model of team work which include trust among all members thus establishing a quality working relationship so as to reach the outcomes. Also, there exists knowledge and trust as well as shared responsibility that eventually causes joint decision making (Jeffery and et.al., 2005). This also includes cooperation and coordination among all practitioners such that it enhances their productivity and help in delivering quality care to the patients.
In this model of team work, a formalized administrative structure is implemented that requires communication and sharing of records of the patient among professionals who are the members of the team (McAllister and et.al., 2014). The members who have been working under me as a part of physiotherapy team are made to gather intentionally to provide treatment to patient. In this model, coordination is maintained by ensuring that a manager is responsible for ensuring that appropriate information is transferred to and from patient as well as practitioners who impart therapy to them. The impact of this model on my overall work practice has been a positive one as this help in bringing coordination among all members of the team to deliver care for patient (Andrews and Read, 2009). This kind of care coordination is needed in between professionals so as to assist in an overall wellbeing of patients. The purpose of providing thus kind of care is to bring an overall improvement in the experience and outcomes of care for the patients (Zwarenstein, Reeves and Perrier, 2005). It is only by adhering towards proper commitment followed by integrated working there can be an effective implementation.
Multidisciplinary team is one which is managed by a leader who plans the patient care. In this, each individual member of the team continues to make their own decisions regarding care to be given to patient which is then integrated by the team leader (Williams, 2012). For example, in the context of physiotherapy the leader can be the main physiotherapist who is an expertise in the field and individual members are other professionals in the same field. Multidisciplinary model has a positive impact on my overall practice as a physiotherapist is a highly articulated one that leads to a formalized growth and coordinated practice (Zwarenstein, Reeves and Perrier, 2005). The main purpose behind making use of this approach is to create an increased coordination between agencies so that a proper checks and balances system can be ensured. This will further assist in overall identification of service gaps and breakdowns between the healthcare agencies as well as individuals. It may further lead to bring an enhancement in professional skills and knowledge (Barr and et.al. 2005). As the staff members belong to interprofessional backgrounds and have different area of expertise. Hence, they bear an overall tendency to respond to the needs and flaws that are being faced by patients.
This model is developed from the multi disciplinary practice when the practitioners that were a team begin to make groups and so here decisions on patient care is facilitated by face to face meetings and also regular ones. This model is also a further development of collaborative model as inter disciplinary team is a group of individuals with diverse backgrounds and training who work together so as to solve complex problems of the patient that might prove too complex to be solved by people belonging to one background (McMurray, 2006). In this, team members determine their mission and common goals, work independently in order to define and treat the problems of the patient and moreover this also help to accept and capitalize on disciplinary differences that exists among all members (Bridges and et.al., 2011). In order to accomplish the shared mission and gaols the members work with a shared leadership that is appropriate according to the problem and thus promotes the use of differences for collaboration as well as confrontation. For example, I have made sure in my physiotherapy department that there is an adoption towards Interdisciplinary model of team work (Zwarenstein, Reeves and Perrier, 2005). Here, professionals like nurses, surgeons, dieticians as well as social workers are made to work together for the provision of appropriate care to patients. Thus, with such inter disciplinary team into practice quality of care can be rendered by the physiotherapist to the patient.
Integrative model consists of an inter disciplinary and non hierarchical blending of conventional medicine and alternative health care like physiotherapy that provides a continuum of decision making as well as care and support that is patient centred. This model is based on specific set of core values which include treating and assisting the whole person as well as assisting in innate healing properties of each person (Andrews and Read, 2009). This also includes promotion of health and wellness and thus preventing of disease for the individual. This model employs an inter disciplinary approach of team which is guided by values of mutual respect, consensus building as well as a shared vision of health care practitioner. This model is one of the latest models of practice of team work that when applied produces positive outcomes for the patients. The impact of this model when used in context of physiotherapy is that since this involves a continuum of aspects that eventually is focussed on patient as well as their needs of support and care.
A comparison can be made in terms of different models that are being used for collaborative needs. On one hand, parallel model has been characterized by the presence of independent health care practitioners who perform their individual work within the specified scope of practice (Zwarenstein, Reeves and Perrier, 2005). It is quite different from other models as an individual is required to perform on its own and there is no interference in the work. The model clearly state towards an absence of tem work but still the individual contributions is likely to benefit the team. This is in contrast with Consultative model where adherence is done towards aspect of consultative thinking so as to decide on overall work. Patients are also given advice by adhering to the process of joint consultation (Barr and et.al. 2005). Collaborative model is similar to consultative model but here, other than consultation there is a need of collaborative efforts as well. Practitioners are required to collaborate with each others in terms of sharing information about the patient so that high quality can be provided. Hence, collaborative efforts is done till the end of decision making so as to satisfy the consumers who are patient. Hence, the model has been found to be based on basic aim being cooperation and coordination among all practitioners. In the above to models there was an absence of a structure (Bridges and et.al. 2011). But the Coordinated model of team work has focused on making use of formalized administrative structure in terms of adhering to a proper communication channel followed by sharing of records. In this regard, responsibilities are thus bestowed on professionals so that there is a transfer of appropriate information through a given channel. The model has been found to be in complete contrast with parallel model where every person is given a chance to perform work on own without any team work (Williams, 2012). However, Consultative model has been found to be quite similar with coordinated model as consultative thinking is given with the help of direct communication through letter or referral note. But still there is no adherence to coordinate work approach which makes it contrast with the other model.
The Interdisciplinary model of team work is different from above mentioned ones as here the individuals are made to work as an inter disciplinary team. Here, the employees belong to diverse backgrounds but work together to sort out the complex issues faced by the clients who come for physiotherapy sessions. The model has been found to be quite beneficial in comparison to above mentioned ones as it is likely to help the physiotherapists belonging to varied backgrounds towards capitalizing on the disciplinary differences and accept them (Zwarenstein, Reeves and Perrier, 2005). Moreover, the model entails for creation of team working between nurses, surgeons, dieticians as well as social workers towards provision of an appropriate form of care (Andrews and Read, 2009). On the same grounds, there is also a presence of another model named as Integrative model which is majorly a merge of inter disciplinary and non hierarchical blending. It entails for incorporating the concepts related to conventional medicine and alternative health care like physiotherapy (Zwarenstein, Reeves and Perrier, 2005).
In my own work practice I have utilized coordinated model of team work. This led to the creation of a formalized administrative structure that proved to be effective in comparison to other models. I focussed on carrying out coordinated actions by making use of communication followed by record sharing with other team members. This has helped in my effective transfer of information from patient as well as practitioners (Andrews and Read, 2009). This has led to increased coordination with team members thereby delivering an effective care for the patients. As per the literature studies coordinated care is provided when there is a presence of complex needs in the patients where emphasis is required to be given on variety of specialists. My work as a physiotherapist entails for treating patients that are suffering from back pain, tennis elbows and ankle sprains. I have to further provide rehabilitation of patients to aid them in recovering from stroke and cerebral palsy. There is also a presence of broad age groups in form of infants and children (Bridges and et.al. 2011). Teenage are also to be taken care of by taking precautionary on account of growth spurts in the bone structures. In the same way, I am also required to deal with geriatric physiotherapy which forms the bulk of entire population. The varied kinds of approach’s has led me to adopt coordinated model of team work to provide safe as well as quality oriented physiotherapy (Barr and et.al., 2005). With this approach, other than physiotherapy, I have also appointed guest dieticians, occupational therapist, physicians so that a coordinated care can be offered to patients. These healthcare professionals pay a visit once a week for checking the requirement in patients or even the flaws that are present in provision of physiotherapy sessions. As per my overall understanding, this kind of coordinated approach in the area of team working has led to provision of care regime which is reliable, timely, and effective as well as of high quality. The model of team work has further b even found to depend on presence of sustained partnerships that exist between n clinicians, providers followed by service users in form of patients.I have felt that the provision of care cannot be coordinated unless the health care providers have been found to work by making use of a structured framework which has been facilitating coordinated delivery of services. Hence, the given coordinated approach to care has helped me in making a strong team of interprofessionals so as to treat the patients who are suffering from disorders that are of varied nature. There has further been a creation of flexible service delivery systems (Zwarenstein, Reeves and Perrier, 2005). Moreover, making use of Effective care coordination has helps in creation of consumer-friendly as well as system-wide approach to provision of care. There has further been an overall improvement in the health of patients as they are being treated by interdisciplinary staff members. The approach further entails towards adhering to provision of care which places patient in the centre of care. Other than this, usage of Multidisciplinary teams have further provided I added benefited to my physiotherapy area. With the help of this, I have tried to involve a wide variety of health professionals who are there to work together for the delivery of a comprehensive patient care. In my area, I have created a multidisciplinary team so as to assist the patients. These are in terms of general practitioners, practice nurses, health educators followed by a good number of physiotherapists. Making use of this approach has led to provide a benefitted approach to patients and the health professionals (Barr and et.al. 2005). There has been an overall improvement in the health related outcomes followed by enhancing the satisfaction of clients. The approach has further led to a creation of efficient use of resources followed by an overall job satisfaction for team members.
I have felt that the provision of care cannot be coordinated unless the health care providers have been found to work by making use of a structured framework which has been facilitating coordinated delivery of services. Hence, the given coordinated approach to care has helped me in making a strong team of interprofessionals so as to treat the patients who are suffering from disorders that are of varied nature. There has further been a creation of flexible service delivery systems (Zwarenstein, Reeves and Perrier, 2005). Moreover, making use of Effective care coordination has helps in creation of consumer-friendly as well as system-wide approach to provision of care. There has further been an overall improvement in the health of patients as they are being treated by interdisciplinary staff members. The approach further entails towards adhering to provision of care which places patient in the centre of care. Other than this, usage of Multidisciplinary teams have further provided I added benefited to my physiotherapy area. With the help of this, I have tried to involve a wide variety of health professionals who are there to work together for the delivery of a comprehensive patient care. In my area, I have created a multidisciplinary team so as to assist the patients. These are in terms of general practitioners, practice nurses, health educators followed by a good number of physiotherapists. Making use of this approach has led to provide a benefitted approach to patients and the health professionals (Barr and et.al. 2005). There has been an overall improvement in the health related outcomes followed by enhancing the satisfaction of clients. The approach has further led to a creation of efficient use of resources followed by an overall job satisfaction for team members.
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It can be concluded from above given study that collaborative practice is a partnership that is attained between providers in the physiotherapist profession and the client by adhering to the approach of shared decision making. It further entails for carrying out communication followed by sharing of skills to improve quality of patient care. I have tried to entail the concept of integrated care in the area of physiotherapy and have found outs huge influence on my overall practice. The improvements have been in the area of reducing costs, quality services which has led to overall satisfaction to users who refer me for varied kinds of illness. A critical evaluation has further been carried out about what is the overall impact of professionalism and professional identity on collaborative practice and effective teamwork.
There is a requirement to adhere with being honest followed by maintaining an overall integrity on their part so that the individuals are able to understand the set of responsibilities followed by providing support to one another. The concept of professionalism fur5ther helps in adhering to collaborative practices with the patients so that an effective team working as well as integration can be brought out. In the similar manner, a key role is further played by effective leadership and how it puts an impact on collaborative practice and team work. Here, as a physiotherapist it is my responsibility to have an understanding about practical concept related to group dynamics followed by maintaining an effective communication. As per my work as a physiotherapist, I have kept a major emphasis on democratic leadership where crucial inputs are taken from team members as well as peers. This has assisted to boost up the morale of other physiotherapists and nurses as they have also been involved in the decision making process.
Type: Dissertation I
Published: 15 Jan ,2020 I
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Type: Case Study I
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Type: Case Study I
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Type: Ph.D. Thesis I
Published: 22 Mar ,2019 I
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Type: Assignment I
Published: 17 Nov ,2018 I
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