Team Interactions in Specialized Palliative Care Teams: A Qualitative Study

Abstract

Background: Teamwork is a standard of care in palliative care and that is emphasized by leading organizations. When interdisciplinary teams communicate their varied assessments, outcomes may be more than additive due to the synthesis of information. Interprofessionality does not guarantee multidimensionality in health care interventions, however, and that interprofessional teams promote collaboration may be questioned. Aim: The aim was to explore team interaction among team members in specialized palliative care teams. Design: Semistructured interviews were conducted with health professionals working in specialized palliative home care teams. The interviews were analyzed by content analysis. Setting/participants: Participants were recruited from specialized palliative care units in Sweden. The 15 interviewees included 4 men and 11 women. Physcians, nurses, paramedical staff, and social workers were included. Results: Organizational issues like resources and leadership have a great impact on delivery of care. Competence was mirrored in education, collaboration, approach, and support within the team; while communication was described as key to being a team, resolving conflict, and executing palliative care. Conclusion: Communication and communication patterns within the team create the feeling of being a team. Team climate and team performance are significantly impacted by knowledge and trust of competence in colleagues, with other professions, and by the available leadership. Proportions of different health professionals in the team have an impact on the focus and delivery of care. Interprofessional education giving clarity on one's own professional role and knowledge of other professions would most likely benefit patients and family caregivers.

Creating a sense of security in palliative home care: Interviews with public health nurses

“…This is consistent with research [26] which reported that teamwork with the patient in the palliative care can create a sense of security for the patient and relatives. Our reflection is that teamwork with different professions is necessary as the care of the patient can be highlighted from several perspectives, which contributes to a holistic view.…”

Interdisciplinary palliative care teams : insights and experiences of chaplain interns and social work interns.

“…Healthcare providers (e.g., physicians and nurses) work together to manage patients, and in the area of palliative care, chaplains and social workers are added to the healthcare team for comprehensive care of the patient. Effective interdisciplinary team characteristics are competence, communication, and organization (Klarare et al, 2013), including leadership, clear vision, quality of care, respect for team roles, and individual characteristics (e.g., listening skills, desire to achieve group goals, and interdisciplinary team experience; Nancarrow et al, 2013). Bronstein's (2003) two-part model of optimal interdisciplinary collaboration describes generic components for positive collaboration between social workers and other disciplines.…”

“…Interdisciplinary teams are constructed of professionals from many disciplines who bring different perspectives to the team to accomplish the complex task of providing palliative care for a patient and their family. A focus on well-defined roles, leadership type, and development of competence between the professions can increase opportunities for useful collaboration among team members and result in higher quality palliative care (Klarare et al, 2013). …”

“…However, team work is complex and barriers and challenges exist that may affect helpful interdisciplinary team interaction. Examples of barriers and challenges that negatively affect interdisciplinary palliative care team functioning are failures in communication (Goldsmith et al, 2010;Mazor et al, 2012), the lack of a common language between team disciplines (Gachoud et al, 2012;Mellor et al, 2002) (Abramson & Mizrahi, 2003;Hartrick-Doane et al, 2012), and role flexibility and ambiguity (Bronstein, 2003;Junger et al, 2007;Klarare et al, 2013;Nancarrow et al, 2013;Wittenberg-Lyles et al, 2008).…”

“…(Cummings, 1998). Klarare et al (2013) reported medical dominance on the teams can cause an imbalance within the stated palliative care mission, which is to provide comprehensive interdisciplinary care to the patient and family. A historical difference between power and responsibility exists between physicians and psychosocial-spiritual professionals that needs clear leadership and reporting structures, as well as training in hospital cultures (Meier & Beresford, 2008).…”