1 Interdisciplinary Collaboration for Elder Care

2 Objectives  Define collaboration and the need for an interdisciplinary approach to geriatric care.  Describe the types of teams and stages of team development  Differentiate education and skills among different professionals on geriatric healthcare teams

3 Objectives  Define the principles of successful teamwork, interdisciplinary collaboration, and steps in the care- planning process.  Discuss the concept of team conflict and conflict management skills.

4 Collaboration is……  shared planning, decision-making, responsibility, and accountability  Importance of collaboration:  Complexity of chronic and acute problems too complex be managed by one provider  Increases likelihood that issues will be addressed  Increases coordination of care  More efficient care delivery

5 Types of Teams  Unidisciplinary Team: same discipline  Multidisciplinary Team: different discipline; members independently develop plan; fixed roles; members are consulted about plan of care; MD assumes leadership  Interdisciplinary Team: different disciplines; flexible roles, collaborative, and synergistic; partners in designing care plan; situational leadership

6 Stage of Team Development  Forming  Forming – creation stage; testing group norms; define boundaries; polite but untrusting; understanding roles  Storming  Storming – confronting stage; friction; jockeying for position; test out each other  Norming  Norming – interdependence; establish norms and patterns; constructive expression of ideas and opinions; heading in the right direction  Performing  Performing – develop solutions; interests are shared; will work together

7 Education and Overlapping Skills  Team members bring unique sets of skills from their discipline  The team looks at medical, psychological, emotional, social, economic, living conditions, and nursing issues and interventions ELEMENTS OF TEAMWORK:  Coordination of services  Shared responsibility  Communication  Mutual accountability

8 Interdisciplinary Collaboration

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10 Effective Meetings Structure 1. Agenda 2. Timeline 3. Roles are defined: Leader or Facilitator Timekeeper Recorder

11 Team Rules…stay on target Attendance and timeliness Prepare materials ahead of time Handling disruptions Contributing to / participating in discussion Appropriate ways to manage conflict Acknowledge other professionals’ roles Share information with respect and cooperation Confidentiality of team discussions Agreement that team goals represents all participants’ views

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13 OVERARCHING TEAM GOALS: Patient’s: Family’s: Team’s: Problem Expected Outcome Impact on Health and Quality of Life Strengths / Resources Plan (Who/What /When) Includes gathering more information

14 Activity: Care-Planning Process Case Scenario: Ms. J Questions:  What team members need to be involved in this case?  What are Ms. J’s most important health issues, and who should be involved in managing these issues?  Develop a management plan for Ms. J.

15 Team Outcomes  Problems identified and discussed; patient and family preferences considered  Medication management and lower cost  Focused on critical problems and set appropriate goals  Social Worker – applying for Medicaid and community services available  Financially feasible medication plan

16 Team Process Evaluation  Negotiate team priorities  Agreed to specific assignments  Clear roles  Stay engaged; group input; no SILO mentality  Specific disciplines provided expert opinions  Follow up plan – Measurable

17 Team Conflict Defined… …competitive or opposing action of incompatibles; mental struggle; opposing needs, drives, wishes, internal and external demands

18 When do conflicts occur? When any team member….  Feels pressure from group to assume a role  Allocated roles are constraining / inhibiting development  Feels that sanctions imposed to induce him or her to maintain a role; are not fair / commensurate  Cannot develop acquired capabilities in assigned role  Wishes to go beyond definition of role

19 Viewpoints on Conflict  Competitive – one must win  Compromising – middle position; all parties give a little to gain  Collaborative – need of both / all are met  Accommodating – avoidance; accommodating

20 Team Communication  Actively listen  Define the problem  Ask open questions  Clarify responses  Paraphrase and Reframe

21 Conflict Management  Attack the problem, not the person.  Focus on what can be done  Encourage different points of view  Express feelings without blaming  Accept ownership  Listen to understand the other person's point of view  Respect the other person's point of view.  Solve the problem while building the relationship.

22 Questions?