Written by Professional Leader – Case Management, Bianca Middleton
Teamwork in health care is not a new concept, but it is one that is constantly evolving. As we celebrate Allied Health Professions Day at Royal Rehab and around the world, we’re taking this opportunity to pause and think about what teamwork really means to us as clinicians and how we are #strongertogether.
Working with a group of allied health clinicians, teamwork is never more apparent than when a client presents a challenging goal. The best part about true multidisciplinary work is having the client at the centre of the team. This is when we really see that an individual clinician will never truly support a client’s objectives alone. It takes a team of people with different insights, specialties, and experiences to assess, prescribe and provide treatment to achieve and succeed. Most of this teamwork occurs behind the scenes, without the client even being aware.
Often rehab teams are presented with cases that may at first glance appear simple, such as a client wanting to return to work. However, rarely is it as simple as a “You’re good to go!” from the doctor. Reflecting on some of the more complex cases, there has been times when all services available have played a role in a client achieving this goal.
Let’s consider the case of Ben, a gentleman in his early 30s who had everything going for him in the IT world until a rash decision resulted in a motorbike accident. Experiencing the effects of a severe traumatic brain injury and multiple orthopedic injuries, what would be required to achieve his goal of returning to work? For such a complex case it’s beneficial to have a case manager to work with the client and the team to coordinate the services needed.
So often, a psychologist is required to promote adjustment to injury and encourage continued engagement when a client is focused on returning to work quickly. An occupational therapist is required to support pacing and scheduling both in the context of cognition and complex pain management. A physiotherapist would work with this client to increase shoulder range of motion and mobility. Dietitian and nursing staff would be involved to provide nutrition and diabetes management and education. An exercise physiologist would support re-engagement in physical activity after an increased sedentary lifestyle post-accident. Recreational therapists would be required to engage the client in a meaningful activity to increase physical and cognitive endurance and promote fatigue management in the preparation for work.
A speech pathologist would address social communication as well as developing strategies to overcome cognitive communication deficits. A social worker would assist with counselling and adjustment support, as well as access to income support through the rehab process and reduce the pressure to return to the workplace before being ready. A vocational rehabilitation specialist may also be required to seek appropriate new employment.
While clients may look at this extensive engagement of people and potentially not see the correlation between them and their end goal, it only takes one of these services to be out of sync, and the whole plan would not be effective. And when we are talking about people’s lives, this fine balance matters.
So, what is the secret behind a successful multiskilled team? Many health services across the world are staffed with multidisciplinary teams but what makes it work more effectively, in some cases compared to others? Evidence tells us that effective communication and coordination, respect and trust, solid implementation strategies, and transparency are key values for successful multidisciplinary teams. Research also suggests that comprehensive policies and procedures are necessary for success (NSW Health, 2020). Considering Australia’s relatively sophisticated health care system, these should be fairly basic expectations, yet does this really answer the question ‘why’?
After 10 years in severe injury rehabilitation in many different roles, and after speaking with various colleagues at Royal Rehab whose experience ranges from 15 years to three months, some key themes emerged.
1. Mutual respect: for each other’s experience and role. A shared passion and considered collaborative communication are all common themes in effective teamwork. This mutual respect for others’ clinical work ensures that all aspects of an individual’s rehabilitation needs are explored and addressed to achieve the best possible outcome. At times when a client may not see the benefit in a particular therapy, another discipline will step in and work collaboratively with their colleague to ensure the client still gets access to an essential intervention. Not one discipline or therapist presents itself as more important than any other, and all respect the client and their support networks.
2. Strong leadership: Reflecting on how we are #strongertogether, the importance of leadership cannot be overlooked. Whilst we’re not considering the qualities of a good leader, extensive research demonstrates the importance of qualities such as being a good role model, having integrity, being an excellent communicator including active listening, and encouraging growth and development – all qualities that we can see reflected in quality multidisciplinary work.
Over the last 20 months, we have faced a global health pandemic that many of us could never have imagined outside of a movie screen. During this time, we have certainly seen the benefits of strong leadership across different clinical backgrounds and the respect they present to each other. We’ve seen senior leaders take the reins in providing clinical care, and allied health staff step up with enthusiasm to support other teams. At Royal Rehab, our sense of purpose has been unwavering with the common goals to keep our clients and each other safe, while delivering the best clinical care possible.
Outside of our own four walls, our allied health colleagues have been called upon to step into roles they never trained for. Often, they’ve had to assist with tasks they never anticipated being part of in their professional careers, often increasing risk to themselves and their families. To everyone who has had to step up and has demonstrated we are #strogertogether, know that you are seen, your work matters, and we thank you.
Today is about celebrating the passion and dedication of our multidisciplinary health care teams. As we celebrate our allied health clinicians today, the intention isn’t to dictate what will make you or your team more skilled. One of the key aspects of multidisciplinary work is that this will always be different from team to team and case to case. Instead, it’s about encouraging us all to take a step back and consider our own work environments. Are we working to be #strongertogether as part of the broader healthcare system, along with our medical and nursing colleagues? Can we look at that client differently? Is there a way we can promote change to benefit our clients and colleagues?
#AHPsDay #AHPsDay2021 #strongertogether #alliedhealth
NSW Health (2020), Multidisciplinary team – Integrated care (nsw.gov.au) Accessed, 05/12/2021