Federal Law Requires Hospice Agencies To Provide Interdisciplinary Patient Care By Stipulating That Each Agency Team Consist Of A Medical Director Essay
Team Communication and Collaboration Jorge Gitler Kaplan University
Federal law requires hospice agencies to provide interdisciplinary patient care by stipulating that each agency team consist of a medical director, nurse, social worker, and chaplain. However, hospice interdisciplinary teams (IDTs) commonly exceed these requirements and include experts in pharmacy, nutrition, physical therapy, and bereavement care (Wittenberg, Parker, Demeris &Regehr, 2009). Based on the previous mandate it remains clear that communication is crucial and necessary, the challenge resides on the ability to maintain a professional and productive level of interaction that will avoid tension between team members, in addition common problems observed are related to the protective nature of their discipline and the impact they can have on the patient care. For example, the competition existing between the nurses and social workers on IDTs has existed for many years (Reese & Sontag, 2001), and confuses roles and responsibilities that cross between scopes and practices.
A lack of understanding across disciplines can be contributed to role competition, role confusion, and role definition, which can lead to friction within the team and isolation of members, and can impede interdisciplinary collaboration and the development of holistic plans of care (Connor, Egan, Kwilosz, Larson, & Reese, 2002).
UC San Diego Moores Cancer Center back in 2005 created a multidisciplinary team with membership from the medical oncology team, the pain service team, nursing, social workers, chaplain, pharmacy, and patient lesion group. In 2007 all the members of the team became certify in palliative care and/or oncology to maximize their ability and knowledge. The communality of these members is the hands on experience and oncology background needed to perform in this team, communication is crucial to everyone in this team.
Dr Mitchell medical director of the palliative care team agrees, “Communication is the cornerstone, wrong information and conflict only hinder patient care.” His role as medical director is not of authority, he serves to bring his expertise to the table and assist patients and caregivers, for him is evident that involving caregivers in hospice interdisciplinary team (IDT) meetings has been offered as a potential solution to caregivers' unmet communication needs (Wittenberg et .al 2009). For his personal development, he participated in Oncotalk, one of many courses such as Fallowfield & Jenkins 2006; Razavi et al. 2003 and Hoffman & Steinberg 2002, all developed in the USA, UK, and Northern Europe, with the intention to improves communications skills, since according to research communication skills do not reliably improve with experience (Moore, Wilkinson, and Rivera 2009). Dr Mitchell also agrees that verbal communication is critical. According to Back, Robert, Arnold, Tulsky, Baile and Fryer (2003) Patients value good communication because they recognize it is centrality to a therapeutic doctor-patient relationship, nevertheless, he emphasizes that non-verbal communications are even more powerful, for example he uses silence, gentile touch and he carefully observes patients and caregiver cues to proceed with the difficult conversations. His refine and evident use of proper communication skill are unmistakable, specifically at the patient conferences and staff meetings where he mentors and guides conversations following techniques that he has mastered during his professional career. In addition, Dr Mitchell brings another factor, according to his experience, communication perhaps is not sufficient to achieve the goals of
