Interdisciplinary teams are at the forefront of modern health systems, providing coordinated and high-quality care to patients to improve outcomes and make departments and facilities more efficient and effective. When silos are eliminated and professionals are able to collaborate and work together across disciplines and departments, the benefits are lasting and wide-ranging. Interdisciplinary teams are more than just coordinated. They complement each other and use a varied skillset to address challenges and achieve vital treatment goals.
‘Interdisciplinary’ is defined as something that covers more than a single branch of knowledge. In academia, it involves multiple disciplines that combine into one activity. The latter definition is more relevant in healthcare as it draws on knowledge from numerous medical fields to improve the standard of care. This is crucial in modern, fast-paced healthcare environments. Physicians or nurses are rarely able to manage every aspect of a patient’s care plan. It commonly involves a variety of professionals and departments.
The World Health Organization (WHO) uses the synonym ‘interprofessional’ for the forms of collaboration that support positive healthcare outcomes. It states that interdisciplinary care involves “multiple health workers from different professional backgrounds work[ing] together with patients, families, carers (caregivers), and communities to deliver the highest quality of care.”
This contrasts with multidisciplinary treatment, which involves different departments but does not feature an integrated approach. Interdisciplinary is often viewed as the best method today as specialist treatment is required at each stage of care. However, it is not a cutting-edge concept. The Institute of Medicine stated that team-based care would deliver a step change in the quality of care and overall safety more than 50 years ago.
Fast forward to today and the WHO constantly stresses that interprofessional teams and treatment are critical to lower-cost, targeted, safe and excellent patient care. A failure to recognize its benefits and create an interdisciplinary culture can undermine the efforts of physicians and caregivers and make it incredibly challenging to achieve key goals and objectives.
Why is interdisciplinary collaboration so important?
It can be argued that interprofessional teams should have always been the de facto setup in healthcare environments. However, the industry has evolved significantly during the last 20 to 30 years. There is now an increasingly aging population in the US. The number of people aged over 65 stood at 52 million in 2018, but is set to almost double to 95 million by 2060. Older people require more healthcare support, especially for long-term illnesses such as diabetes and other chronic issues. An interdisciplinary team is required to administer and manage such complex treatments.
Healthcare is also becoming more specialized, with many professionals acquiring a skillset that is focused on a specific niche or field. This means that more professionals need to collaborate and work together to provide the comprehensive treatment that patients need. An interdisciplinary approach connects each department and reduces fragmentation. This collaboration also eliminates blind spots and makes it easier to implement treatment plans.
Specialization has also been driven by advancements in healthcare, which require qualified nurses and professionals with a higher capacity for learning and skills. This could potentially be a problem in the US if skills shortages persist. The nurse practitioner shortage is particularly acute at the moment – to find out more about this shortage and how to become a nurse practitioner, read Rockhurst University’s blog linked to above. A report published by the Association of American Medical Colleges shows that a dearth of skills could lead to a shortage of up to 48,000 primary care physicians by 2034.
To combat these shortages, nurses in the sector with a bachelor’s degree could earn a degree to become nurse practitioners. The good news is that professionals in healthcare can often complete programs such as an MSN-FNP completely online. This means that they don’t have to leave their current roles or relocate to campus. The full-time and part-time options available also enable nurses to gain the skills they need at a pace that suits them.
What are the benefits of interdisciplinary collaboration?
Interdisciplinary collaboration is a dynamic process that features multiple healthcare professionals using their skills to achieve a common goal – in this instance, assessing and creating a patient care plan and then implementing it successfully. Professionals in these teams are still able to retain their autonomy in certain aspects, but always communicate freely and consistently. This open and collaborative approach delivers a level of care that simply wouldn’t be possible for a single person or an unconnected healthcare team.
A report published titled ‘Ten Principles of Good Interdisciplinary Team Work’ outlines clearly the characteristics required for an interdisciplinary team to work effectively.
These principles are:
- Positive leadership
- Training and development
- Supportive team climate
- Clear vision
- Respect for each role
- Optimal skill mix
- Robust communication structures
- Effective procedures
- Unique individual skills
- Personal rewards
Positive patient care outcomes
When these principles are met and teams adopt a holistic approach to patient care, the impact on outcomes is considerable. This is because the unique skills and invaluable insights proffered by each team member enhance the overall level of care. If a patient is only being treated by a single specialist, a single aspect of care might be excellent, but the lack of skills in other areas could make comprehensive treatment very challenging. This issue is resolved when multidisciplinary teams treat a patient.
A case study for this might involve a patient who is struggling with chest pains walking into an emergency department. Later, the pains turn out to be the symptoms of a heart attack. During the next 24 hours, qualified nurses and physicians from a range of departments will consult with each other and work together to diagnose and treat the patient. A cardiologist will order tests and the radiologist will conduct them. A team of nurses also provide round-the-clock care based on the information and advice provided by the cardiologist and radiologist.
When the patient eventually recovers and becomes an outpatient, a number of different professionals will have given their unique insights on them and collaborated to ensure that the quality of care always meets the highest standards. New forms of technology have made the interdisciplinary process easier. It is now possible to communicate via video calls and messaging apps to coordinate the treatment that helps a patient recover. All of this contributes to more positive outcomes.
Fewer medical errors
Interdisciplinary teams vastly reduce the number of errors made during the treatment journey, which is beneficial for caregivers, the healthcare facility and patients. Medical errors can be fatal in certain circumstances. When someone is misdiagnosed or symptoms are not spotted, it can lead to longer, more costly courses of treatment, while also raising the risk of death. An effective interprofessional team will dramatically reduce oversights and ensure that treatment is safe and secure.
Faster treatment
When robust communication channels are in place and departments and specialists are in sync, it is easier for those responsible to conduct tests, make a diagnosis, and create effective treatment plans. An example of this in action would involve a lab specialist notifying an orthopedist immediately about the results of a test so that the latter can make a formal diagnosis. A disconnected team might struggle in this instance, leaving vital data sitting around and lengthening the time it takes for a patient to start treatments. This example is just a single process in patient care. It can cause real issues when multiple inefficiencies force delays in treatment. Reducing waiting times is beneficial for everyone involved, including the health facility.
Improved efficiency
These faster treatments are also more efficient overall. Streamlined processes supported by a specialized and interprofessional team deliver more consistent and less error-prone services. This is because correct decisions and accurate treatments reduce the need for superfluous actions and additional tests and examinations. Patients benefit from higher standards of care, which then reduces the time it takes to discharge them from hospital. Health facilities benefit again by being able to admit more patients and better optimize care plans, while also having to spend less on treatment and overall care.
Increased efficiency is backed up by research. A study by the Robert Wood Johnson Foundation found that interdisciplinary teams delivered vastly improved metrics for bed turnover, discharge rates and the average length of stays. There is also a tangible impact on patients in terms of saving lives. A collaboration model reduced delays for surgery, fast-tracked start times and eliminated hundreds of wasted hours. These inefficiency improvements can be transformative for the level of care that a patient receives.
Better morale
The positive effects reverberate beyond decision-making. Interprofessional teams are commonly more motivated and have better morale. One of the 10 principles of the interdisciplinary collaboration model involves personal rewards and regularly recognizing the contribution and value that each team member brings. When nurses and physicians feel more valued, they are less likely to suffer from stress and burnout, and more likely to be engaged and make better decisions. A more harmonious team boosts morale. This helps the patient, who receives better care and is actively encouraged and supported by the team.
What are the challenges when implementing an interdisciplinary model?
The teamwork of multidisciplinary healthcare professionals can be transformative for patient outcomes, then, but is an interprofessional model easy to set up and manage? Hospitals often face challenges when eliminating silos and connecting departments. Problems that often manifest during the process and undermine collaboration efforts include issues with trust and respect, power struggles, a lack of understanding of roles, and poor task management.
Poor communication
Effective communication is the first rule for interdisciplinary teams, but there can be cases where this breaks down if the right infrastructure is not in place. Miscommunication can occur when there is confusion about what documentation and reporting systems must be used. That’s why nurses and physicians often advocate for accessible platforms that are compatible with data management systems. Putting effective communication best practices in place is key. This involves regular clinical rounds, where the medical team visits the patient and their family as a group to ensure that the treatment is going as planned and the patient’s health is improving.
Staff meetings are also crucial to share understanding and set out the priorities for the day ahead. Communication is central to every aspect of the multidisciplinary approach, so this should be the starting point when creating teams, assigning tasks, and coordinating care and treatment. Successful interprofessional collaboration flows from effective communication.
Absence of trust and respect
Respect and trust are also important factors. When team members support each other, and more crucially, listen and take on board different opinions, the interdisciplinary approach works better. Unfortunately, there are often times when physicians are reticent about listening to a recommendation from a nurse or other professional. This can cause conflict, which then negatively affects the treatment strategy. The good news is that great strides have been made in creating a culture of respect and trust in healthcare environments during the last 20 years. Peers are now more likely to listen to each other and be compassionate. Even if there are differences of opinion, they should be aired in a way that ensures that team members don’t feel disrespected or belittled.
Power struggles
A lack of respect or conflict can also result in power struggles and autonomy disparities, which can undermine the efforts of certain team members. There are many routes to a career in nursing and healthcare. Each professional will have their own unique journey, but they will all have the necessary qualifications for the job at hand. In the past, nurses might have been viewed as mere assistants to physicians, but this stereotype is changing. Nurses are now becoming nurse practitioners and earning degrees to improve their leadership skills. This will enable them to better manage power struggles and ensure that their opinions are heard. It will also give them an opportunity to use their problem-solving and critical-thinking skills to benefit the wider team.
Lack of understanding of roles
Trust and respect can be enhanced when team members have a complete understanding of each other’s roles. Unfortunately, it can be common for physicians and nurses to be incredibly proficient in their own sphere of influence, but unaware of the responsibilities of others. When team members don’t know the details of another person’s role, it can create inefficiencies and collaboration is made more challenging than it needs to be. For example, a nurse might not comprehend the tools and methods that a physical therapist uses to treat a patient with a musculoskeletal disorder and might overlook an obvious core treatment as a result. Again, getting team members together and holding regular meetings will enable everyone to learn and understand the diverse roles at play and how everyone can work together to deliver high-quality treatment plans.
How can interdisciplinary collaboration challenges be addressed?
Integrated care delivered by an expert team that complements each other’s skillsets and communicates effectively is the end goal. There has been a lot of discussion and studies published about how to achieve this ambitious but vital objective in healthcare. Experts agree that improving communication structures is key. Putting structures in place can involve standardizing handoff reporting tools so that every team member has all the information at their disposal to complete their jobs effectively. Some hospitals have also seen success in increasing shift lengths from eight to 12 hours as this also improves handoff communication.
From here, working through the ‘10 principles’ outlined earlier is the best way to create a collaborative and supportive team culture capable of providing care that improves patient outcomes. One factor that should also be prioritized is shared accountability. This doesn’t mean diminishing the efforts of others or establishing draconian rules to punish mistakes, but instead promoting a healthy culture of feedback and guidance. Interdisciplinary teams will struggle to work if physicians and nurses feel like they cannot communicate their feelings and outline what they need to perform their jobs effectively. Again, regular meetings and shared governance will ensure that voices and ideas are always heard.
Nurses often state that a lack of time and resources can hold back their interprofessional efforts. Nurses have to conduct a wide range of tasks during a shift, which can make it difficult to devote time to collaborative activities. Experts recommend establishing a ‘coverage’ plan where other nurses can fill in for short periods to take phone calls and complete smaller tasks while the team member focuses their efforts on coordinating treatment plans and completing clinical rounds.
Finally, promoting shared leadership will help to reduce the chances of conflict and power struggles. Leadership should be fluid and change based on each stage of the treatment plan. The team might recognize that a specific team member might be best to take the baton for the initial stages of treatment before it switches later to another professional. All of these efforts will help to set up effective interdisciplinary teams and combat any challenges that arise, which can be transformative for the level of care delivered across the healthcare industry.