IENE5(Intercultural Education of Nurses in Europe Project 5) Introducing topic 2: Multicultural multidisciplinary health team

What are multidisciplinary teams? Multidisciplinary and multiagency working involves appropriately utilising knowledge, skills and best practice from multiple disciplines and across service provider boundaries, e.g. health, social care or voluntary and private sector providers, to redefine, re scope and reframe health and social care delivery issues and reach solutions based on an improved collective understanding of complex patient need(s). (NHS England)

What are multidisciplinary multicultural health teams? Teams which comprise of individuals from a diverse range of cultural backgrounds and from different disciplines, working together in a healthcare setting , caring for a diverse group of patients.

Why are MMHT important? Its important to be able to work together as a team, in other words, as a ‘well-oiled machine’. Even though in a MMHT everyone has different roles and responsibilities, being aware of these can help you to focus on doing your own job to the best of your ability(caring for your patients), and to make the best use of everybody’s unique skills and knowledge to work together with your colleagues to meet the needs of the patient. If everyone is working together and there is a culture of collaboration rather than competition, there is no toxic culture, everyone gets on well, staff have better wellbeing and are less likely to get burned out. Hierarchies exist but people should not feel afraid to speak up if there is a problem. There should be a culture of openness.

Research papers Manser (2008) Good teamwork is associated with fewer adverse events Staff wellbeing is important for patient safety (burned out staff are less able to ensure safety of patients) Gillespie (2010) Education helps with improving communication between team members Organisational systems and beauracracy can sometimes cause conflict between team members

When poor team-working contributes to failings of care Between 2004 and 2008, a number of mothers and babies died due to serious incidents at Morecambe Bay NHS Trust’s maternity services. Kirkup’s (2015) investigation revealed many failings within the entire healthcare system, including: Poor relationships between staff from different disciplines (e.g. obstetricians, paediatricians and midwives) Inadequate procedures and processes Staff not trained properly (didn’t have the technical or clinical skills for the job) Staff not doing proper risk assessments Not reviewing incidents to see what went wrong, whether similar events had happened before, and making a plan to prevent it happening again Senior staff and executives either not escalating the incidents or not investigating the incidents when they were informed Denial/collusion by the staff when giving evidence Missed opportunities to intervene by regulatory bodies such as the CQC

Conclusions and relevance to other topics in the MOOC Effective intercultural communication is necessary when working within a MMHT, to enable staff to communicate effectively and prevent misunderstandings Good team working can help to ensure better patient safety and avoid incidents

Resources NHS England has published some guidelines for people working in MDTs: https://www.england.nhs.uk/wp-content/uploads/2015/01/mdt-dev-guid-flat-fin.pdf King’s Fund report on leadership: http://www.kingsfund.org.uk/sites/files/kf/leadership-whole-systems-welbourn-warwick-carnall-fathers-leadership-review2012-paper.pdf