Interdisciplinary team working in physical and rehabilitation medicine

Abstract

Effective team working plays a crucial role in Physical and Rehabilitation Medicine (PRM). As part of its role of optimizing and harmonizing clinical practice across Europe, the Professional Practice Committee of Union of European Medical Specialists (UEMS) Physical and Rehabilitation Medicine (PRM) Section reviewed patterns of team working and debated recommendations for good practice at a meeting of national UEMS delegates held in Riga, Latvia, in September 2008. This consensus statement is derived from that discussion and from a review of the literature concerning team working. Effective team working produces better patient outcomes (including better survival rates) in a range of disorders, notably following stroke. There is limited published evidence concerning what constitute the key components of successful teams in PRM programmes. However, the theoretical basis for good team working has been well-described in other settings and includes agreed aims, agreement and understanding on how best to achieve these, a multi-professional team with an appropriate range of knowledge and skills, mutual trust and respect, willingness to share knowledge and expertise and to speak openly. UEMS PRM Section strongly recommends this pattern of working. PRM specialists have an essential role to play in interdisciplinary teams; their training and specific expertise enable them to diagnose and assess severity of health problems, a prerequisite for safe intervention. Training spans 4-5 years in Europe, and includes knowledge and critical analysis of evidence-based rehabilitation strategies. PRM physicians are therefore well-placed to coordinate PRM programmes and to develop and evaluate new management strategies. Their broad training also means that they are able to take a holistic view of an individual patient's care.

Nursing Roles and Functions in the Acute and Subacute Rehabilitation of Patients With Stroke

“…The team is composed of members with different professional backgrounds. Working in teams, the key feature of success is to agree on aims of the intervention using a shared strategy and mutual trust and respect (Neumann et al, 2010). The nurses' request might be seen as a result of the struggle to collaborate between professions.…”

Interdisciplinarni timski rad – izazov u suvremenoj rehabilitaciji

“…Interdisciplinarni timski rad temelji se na fundamentalnim medicinskim principima, ICF-ovu modelu tjelesnih funkcija, struktura, aktivnosti, participacije i okolišnih čimbenika te znanstveno potkrijepljenim (evidence based) rezultatima u zdravstvenoj skrbi 13 . Interdisciplinarni model jest preferirani model u rehabilitacijskoj skrbi 14 jer aktivno uključuje onesposobljenu osobu i njezinu obitelj u rad s profesionalcima raznih struka na zajedničkoj zadaći složenoga rehabilitacijskog procesa 3 .…”

“…Fizioterapeuti i medicinske sestre s odjela interne klinike i odjela rehabilitacije veći-nom smatraju (56,8 %) kako rade u interdisciplinarnom timu, uz pokazatelj znatno bolje otvorene komunikacije na odjelu rehabilitacije 18 . Timska suradnja interdisciplinarnog tipa u rehabilitaciji primjere dobre kliničke prakse prikazuje kod neuromuskularnih bolesti 6 , ortopedije 19 , ortotike 20 i protetike 3 , fizikalne medicine i rehabiltacije 21 i cerebrovaskularnih bolesti 22 , no budući da u većini dostupne literature odnosi između članova tima nisu točno specificirani 13 , a imaju elemente interdisciplinarnosti, možemo smatrati da postoje dokazi o prihvaćenosti pristupa i u drugim područjima.…”

Strengthening health-related rehabilitation services at national levels

“…The WHO list of health professionals has some weaknesses from the perspective of rehabilitation (14). The list does not reflect the professions identified by Neumann et al (15) (Box 2). The definition of rehabilitation professionals from the WRD does not reflect the differentiation we believe is necessary for provision of a high-quality rehabilitation service.…”