Thinking teams thinking clients: issues of discourse and representation in the work of health care teams.

Abstract

The use of multi-disciplinary health care teams is an increasingly common aspect of service delivery in health care in Western countries. While the literature rehearses the putative benefits to practitioners and clients of such teams, there appears to be an absence of extensive evidence-based research on team practices to substantiate such claims. What evidence there is suggests that team work is in different ways problematic. This article is a progress report on a qualitative research project into the operation of health teams with responsibility for clients in hospitals and the community in New Zealand. The first part of the article presents some of the main themes in current research on health care teams. The second part argues that effective team work requires giving attention to a hitherto marginalised dimension of teamwork -the team's reflexive and representational practices. Attention to these practices appears to be particularly important in complex cases or when the team believes that its work with the client is not progressing as well as it might. The article concludes by highlighting the sociological significance of representational issues in team work and by drawing some inferences about factors affecting effective teamwork.

The Area and Community Components of Children's Well‐being

“…For instance, the pace of implementation of the more preventive and community-focused public health agenda, within the National Health Service (NHS), has resulted in some reactionary responses, with staff often falling back on the traditional medical model, with doctors in the lead role and individual approaches to treatment and cure to the fore (Mackian, 2002). Organisations of this size and complexity need time to enable the sort of critical self-awareness and reflexivity required to facilitate major cultural changes of this nature to develop and flourish (Opie, 1997). Unfortunately, in the present political climate, calls for more time are inevitably interpreted as a sign of opposition to reform that simply has to be swept aside.…”

Integrating health and social care: Interprofessional relations of multidisciplinary teams in Italy

“…Opie (1997) suggested three different types of teamwork, namely, multidisciplinary, interdisciplinary and transdisciplinary. Multidisciplinary teamwork means that different professionals perform parallel tasks, each of them uses their own competences to a common end.…”

“…Especially, attention has been given to obstacles and barriers to integration. These include power relations, with a special reference to the dominant position held by the medical profession; the propensity of each profession to defend its own jurisdiction; and the existence of different professional cultures and values, which generate interprofessional tensions (Brown et al, 2011;Cameron, 2011;Chapham et al, 1995;Colombo et al, 2003;Farrell et al, 2001;Hansson et al, 2008;Hugman, 1995;Irvine et al, 2002;Leutz, 1999;Marsh, 2006;Opie, 1997;Rummery and Coleman, 2003;Sanders and Harrison, 2008;Shaw, 2008;Wilmot, 1995).…”

Competence, respect and trust: Key features of successful interprofessional nurse-doctor relationships

“…Possible reasons previously identified for ineffective teamwork have included lack of training to work in teams and lack of time to engage in open communication, but also inaccurate professional stereotypes and perceived inequalities in status (Carryer, 1999;Opie, 1997;Regan, 2005;Ross, 2001;Toop & Hodges, 1996a, 1996b. However, these claims have been supported with little empirical data, and what data exists predates the introduction of the current primary health care strategy.…”