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TEAMWORK In Rehabilitation Settings

In Rehabilitation Settings, What Are The Overarching Goals for Its Clients?:

In Rehabilitation Settings, What Are The Overarching Goals for Its Clients? 1. Maximize Functional Abilities 2. Maximize Psychosocial Abilities 3. Improve Quality of Life 4. Improve the 3 dimensions of disability Impairments Activity Limitations Participation Restrictions

Three Dimensions of Disability:

Three Dimensions of Disability Impairment: any loss or abnormality of psychological, physiological or anatomical structure or function. Impairment is considered to occur at the level of organ or system function . Activity Limitation : any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being . Participation Restrictions: A re problems an individual may experience in involvement in life situations. The presence of a participation restriction is determined by comparing an individual's participation to that which is expected of an individual without disability in that culture or society. ICF – International Classification of Function

Team Definition: but first, a word about COMMUNICATION:

Team Definition: but first, a word about COMMUNICATION What’s Communication? Analogy: Communication and Water Can a team exist without communication? TEAM: A group of individuals who are committed to a shared purpose, to each other, and to working together to achieve a common goal Keywords : Individuals – Shared purpose – Commitment – Goals - Uniqueness


TEAM APPROACH The Team Approach in Rehabilitation is Directed Towards Working together with the PATIENT and FAMILY and the Whole Medical Team To Assist a person with an injury or disability r each their MAXIMUM potential

While the Evidence is slowly emerging on the benefits of Teamwork in rehabilitation settings: :

While the Evidence is slowly emerging on the benefits of Teamwork in rehabilitation settings: Most healthcare professional agree that teamwork provides comprehensive patient care and better functional outcomes for patients

Qualities of Effective Teams :

Qualities of Effective Teams Clear, open and effective lines of communication Goals clearly stated Sufficient resources available Commitment to process and product Ongoing evaluation of interactions and service Trust is built and maintained Leadership is strong Organizational support for teamwork is available Systems thinking prevails

Team Work: Multi-disciplinary Approach:

Team Work: Multi-disciplinary Approach Members from different disciplines working independently on problems either in parallel or sequentially Working WITH two or more disciplines (vs. working BETWEEN several disciplines) Individual goals in different professions Participants have separate but inter-related roles Participants maintain own disciplinary roles

Did he get there alone?:

Did he get there alone?

Why Teams?:

Why Teams? There are many objects of great value to man which cannot be attained by unconnected individuals but most be attained if at all, by association. Daniel Webster

Why Teams?:

Why Teams? Federal Law – Individuals with Disabilities Education Act (IDEA): “…services should be provided by a variety of disciplines.” Required by the Joint Commission Literature in organizational development supports the importance of group versus individual efforts.

WHY Teams?:

WHY Teams?

Determinants of Effective and Non-Effective Teamwork in Rehabilitation Settings:

Determinants of Effective and Non-Effective Teamwork in Rehabilitation Settings Effective Clear aims and priorities Clear lines of accountability Understanding of the team process and the team members’ role and responsibility within it. Recognition of the importance of operational procedures and culture Respect the other’s skill set and responsibilities within the clinical setting Non-Effective Differences in priorities/aims Confusion over accountability Poor understanding of the team process and roles and responsibilities within it Failure to recognize operational procedures and culture Inadequate respect for other’s skill sets and responsibilities

Characteristics of Effective Health Care:

Characteristics of Effective Health Care Client centered Client is involved in treatment Goal oriented Outcomes oriented Comprehensive – Involving the health care team Holistic Systems (theory) approach

Team Work: Interdisciplinary Approach:

Team Work: Interdisciplinary Approach Working BETWEEN TWO disciplines Involves TWO disciplines (i.e., focuses on reciprocal action of discipline) Members from different disciplines working together on the SAME PROJECT, WORKING JOINTLY SHARED goals Participants SURRENDER some aspects of their own discipline BUT still MAINTAIN a discipline specific role

Team Work Inter-disciplinary Approach:

Team Work Inter-disciplinary Approach GOALS Client/Patient

Team Work: Trans-disciplinary:

Team Work: Trans-disciplinary Working ACROSS AND BEYOND SEVERAL disciplines Involves providers from relevant disciplines, as well as STAKEHOLDERS Members from different disciplines working together using A SHARED COMMON FRAMEWORK Shared goals and shared skills Participants have role release and role expansion Participants develop a SHARED FRAMEWORK drawing together disciplines

Team Members in Rehabilitation Centers (Multidisciplinary):

Team Members in Rehabilitation Centers (Multidisciplinary) Patient and Family (#1 members) Physician – usually the team leader in a multidisciplinary approach Nursing PT and OT Clinical Social Worker Speech/Language Pathologist Psychologist, Psychiatrist, or Neuropsychologist Recreation Therapist Audiologist Registered Dietitian Vocational Therapist Orthotist and Prosthetist Respiratory Therapist Case Manager Chaplain

P I C O:

P I C O P I C O Problem or Patient or Population Intervention/Indicator Comparison Outcome of interest Example Mrs. Smith S/P THA PT/OT and ? No PT/OT and only ?, PT/OT and? Able to return to PLOF (prior level of function)

Show Me the Evidence: Use PICO:

Show Me the Evidence: Use PICO Are efforts to involve several disciplines really useful? Should we involve multiple disciplines in every case? What are the difficulties in carrying out an approach that demands teamwork?

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