how multidisciplinary collaboration can affect clinical decision making.
Collaboration is a major
component in the successful diagnosis and treatment for the patient. Regardless
of the indication for collaborative care, co-management must include ongoing
communication among providers to ensure patient safety (Baily et al., 2006;
Brooten et al., 2005; Zwarenstein et al., 2009). The structure of
interprofessional communication varies among clinical sites by typically
includes periodic clinical conversations about specific patients and management
plans either through telephone or in person. Interprofessional practices may use
regular meetings to discuss high risk patient caseload. This formalizes the co-management process and
ensue timely review of patients evolving health status. These communications
should be documented in the medical record in addition to standard written
consultant reports and routine charting following clinical encounters. (Collin-McBride
& Saxe 2013).
how collaboration can lead to improved patient outcomes.
Effective teams are characterized by trust,
respect, and collaboration. Deming is one of the greatest proponents
of teamwork. Teamwork, he believes, is endemic to a system in which all
employees are working for the good of a goal, who have a common aim, and who
work together to achieve that aim. When considering a teamwork model in health
care, an interdisciplinary approach should be applied. Unlike a
multidisciplinary approach, in which each team member is responsible only for
the activities related to his or her own discipline and formulates separate
goals for the patient, an interdisciplinary approach coalesces a joint effort
on behalf of the patient with a common goal from all disciplines involved in
the care plan. The pooling of specialized services leads to integrated
interventions. The plan of care considers the multiple assessments and
treatment regimens, and it packages these services to create an individualized
care program that best addresses the needs of the patient needs. is
important to point out that fostering a team collaboration environment may have
obstacles to overcome: additional time; perceived loss of autonomy; lack of
confidence or trust in decisions of others; clashing perceptions;
territorialism; and lack of awareness of a provider’s education, knowledge, and
skills held by colleagues from other disciplines and professions. However,
most of these obstacles can be overcome with an open attitude and feelings of
mutual respect and trust. A study determined that improved teamwork and
communication are described by health care workers as among the most important
factors in improving clinical effectiveness and job satisfaction. (O’Neil &
how lack of collaboration can lead to poor patient outcomes.
Lack of collaboration can
lead to incorrect diagnosis, failed labs that needed to be obtained or failure
to properly refer patient to a specialist or even the emergency room treatment.
Especially as a new practitioner there may be times when the practitioner is
unsure of the plan they devised for the patient. Instead of leaning on the
expertise of the colleagues, either because of fear of being thought of as
unknowledgeable or unable to function autonomously they proceed with doubt, as
they implement the plan which could lead to very poor outcomes for the patient.
It is imperative that practitioners encourage each other and utilize each
other’s knowledge base to deliver quality care and ultimately good outcomes for
three barriers to professional collaboration among healthcare professionals and
There are several barriers
that may hinder professional collaboration in healthcare including gender where
men may feel superior to women. The doctor may have developed a perception
about nurse practitioner that they don’t know as much as they need to know to
practice a safely, and may belittle or demean the practitioner when she asked
questions. Other barriers include age, body language which may present
unfriendly or unwelcoming. In addition, cultural and ethnicity may play a part
in how people interact with each other, thereby causing a professional barrier
if one is perceived as unapproachable.
are the five best ways to promote professional collaboration in pediatric
Patient- and family-centered care is
grounded in collaboration among patients, families, physicians, nurses, and
other professionals in clinical care as well as for the planning, delivery, and
evaluation of health care, and in the education of health care professionals
and in research, as well. These collaborative relationships are guided by the
to and respecting each child and his or her family. Honoring racial, ethnic,
cultural, and socioeconomic background and patient and family experiences and
incorporating them in accordance with patient and family preference into the
planning and delivery of health care.
flexibility in organizational policies, procedures, and provider practices so
services can be tailored to the needs, beliefs, and cultural values of each
child and family and facilitating choice for the child and family about
approaches to care.2
complete, honest, and unbiased information with patients and their families on
an ongoing basis and in ways they find useful and affirming, so that they may
effectively participate in care and decision-making to the level they choose.
Health information for children and families should be available in the range
of cultural and linguistic diversity in the community and take into account
health and basic literacy. In hospitals,
conducting physician rounds in the patients’ rooms with
nursing staff and family present can enhance the exchange of information and
encourage the involvement of the family in decision-making.
and/or ensuring formal and informal support (eg, peer-to-peer support) for the
child and family during each phase of the child’s life. Such support is
provided so that Health Insurance Portability and Accountability Act and other
relevant ethical and legal guidelines are followed.
with the ethics of fidelity. When the practitioner indicates she is going to do
something. make sure it is done. This further builds a strong, supportive and trusting
rapport with the patient.
How can the nurse practitioner encourage and support collaboration among
the patient, family, caregivers, and healthcare professionals?
Collaborating with patients and families at
all levels of health care: in the delivery of care to the individual child; in
professional education, policy making, program development, implementation, and
evaluation; and in health care facility design. As part of this collaboration,
patients and families can serve as members of child or family advisory
councils, committees, and task forces dealing, for example, with operational
issues in health care facilities; as collaborators in improving patient safety;
as participants in quality-improvement initiatives; and as leaders or coleaders
of peer-support programs. In medical research, patients and families should
have voices at all levels in shaping the research agenda, in determining how
children and families participate in research, and in deciding how research
findings will be shared with children and families. Recognizing
and building on the strengths of individual children and families and
empowering them to discover their own strengths, build confidence, and
participate in making choices and decisions about their health care. (O’Neil & Rosenstein 2008).