Team Work

Every Multidisciplinary team is composed of different professionals, possessing a variety of skills necessary to produce safe and effective care.

This includes:

·        general practitioners;

·        practice nurses;

·        allied health professionals such as physiotherapists, occupational therapists, dieticians, psychologists, social workers, podiatrists and Aboriginal Health Workers;

·         health educators - such as diabetes educators - providing promotion and prevention clinics and other activities.

Multidisciplinary teams convey many benefits to both the patients and the health professionals working on the team. These include improved health outcomes and enhanced satisfaction for clients, and the more efficient use of resources and enhanced job satisfaction for team members.

What makes healthcare teams so different from those in other types of organisation is that team members have differing allegiances, not only to the team but also to their professional groups. History and professionalism play their part in making questions of authority and responsibility in the health service team much more complex. Clarity about authority and accountability in health care teams is essential.

To ensure optimal functioning of the team and effective patient outcomes, the roles of the multidisciplinary team members in care planning and delivery must be clearly negotiated and defined.

This requires:

·         respect and trust between team members;

·         the best use of the skill within the team;

·         agreed clinical governance structures;

·         agreed systems and protocols for communication and interaction between team members.

I feel as though the Entabeni rehab and multidisciplinary team have made an effort to show interest in us as students joining their team. They offer us advice, communicate with us about changes and time slot conveniences and have adapted to us being in their environment twice a week. We are blessed with the staff the rehab has.

This week I performed a self-care grooming and LL dressing treatment sessions with Ms. Thobeka. The client also improved in her transfer abilities this week , as she was able to transfer from the wheelchair to the bed safely but with supervision. However, she required help to transfer back to the wheelchair. The client performed LL dressing and undressing with moderate assistance in a sufficient time. The client was required to weight bear on the subluxated affected right arm during grooming (Face washing and teeth brushing). I have seen great improvement in the client’s dynamic sitting balance (Trunk control). I have performed NDT techniques to improve her Trunk control each prac day.

Mrs Pillay is being discharged on Friday. This client’s dynamic standing balance was my main focus of treatment in these last few weeks. In my session I learnt the importance of ensuring the client is weightbearing on the affected leg and not neglecting it. This was tricky to focus on when also assisting the client with the co-ordination peg board activity. The client was asked to lift her left heel to ensure weightbearing in the last 6 minutes of the activity and the student therapist focused more on knee extension than the second half of the activity which was an easier task. Through this activity the student noted the importance of adaptation to meet the aims and the importance of multitasking as a therapist for all aspects of the sessions requirements.

 Unfortunately my client was unwell with stomach problems on Wednesday and I therefore didn't get to perform my last treatment session with her.

Mrs Mabongo is my new T6/7 SCI client. We performed a shuffling activity today as the client struggled in this area when she was assessed. This is important for mobilization to get into positions for therapy, as well as for her transfer she performs at the moment with a transfer board. The client understood the new techniques taught to her and great improvement was noted by the end of the session through repetition. The client did not understand the initial game for the pegboard despite multiple demonstrations and it was therefore downgraded to just removal of the pegs. The activity required trunk rotation of the left and right side to improve trunk control. It also incorporated weighted cuffs. My supervisor noted it wasn’t necessary. I agreed with this feedback as the only step of the activity it may have improved MS for is the elevation and reach the client was required to perform when removing the pegs. The client's heavy flaccid LL's provided enough resistance to increase MS of the UL's.

References:

1. Health One NSW. (2014). Multidisciplinary Team Care. https://www.health.nsw.gov.au/

healthone/Pages/multidisciplinary-team-care.aspx

2. Jenkins, V. (2001). Multidisciplinart Teamwork: The good, bad and everything in between. https://qualitysafety.bmj.com/content/10/2/65