Professional Documents
Culture Documents
Foster & Fleming, 2008). Today, our understanding of health extends not only to the optimal
functioning of body structures, but to how this functioning affects participation in a personal and
environmental context (World Health Organisation WHO 2001). Health care consumers are more
educated regarding their health and are required to take greater responsibility for their health outcomes.
Subsequently, an intervention that focuses not on disease, but rather on the empowerment of the
patient and their social, psychological and physical treatment needs, requires active participation of
several health care disciplines and professionals (Stewart, Brown, Weston, McWhinney, McWilliam,
& Freeman, 2003). Thus many health care facilities are now adopting an interdisciplinary model for
treatment, such as aged care wards at Melbourne’s Caulfield General Medical Centre (CGMC) where
the benefits of its effectiveness were undoubtedly supported by first-hand clinical experience on
student placement.
perspectives collaborating in a manner so that the sum of the effort is greater than how each discipline
might interpret a situation…individually’ (Redman, 2006, p105). Further to this, the inclusion of the
patient as a part of this team is generally ideal (Wiecha & Pollard, 2004) and should be considered for
health care context, is to ensure that thorough care plans are developed for each patient in a manner
that addresses the increasing complexity of client needs in this day and age (Cooper, Carlisle, Gibbs &
In the context of the changing needs of today’s patients, there are several key potential benefits of
interdisciplinary practice that enables this model of health care management to best support the
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achievement of an optimal health workforce. This practice not only encourages, but requires,
improved communication between team members (Bynon, Eyres & Maguire, 2008). It could be said
such communication is the essence of best care in health, as lack of communication between
professionals and between patient and therapist is often the cause of harm in health care (Drinka &
Clark, 2000). Communication between interdisciplinary team members is most often maintained at a
high level through regular team meetings, such as was utilized at CGMC. Each inpatient was
discussed twice weekly by all professionals relevant to their health and welfare care, in which time
therapy goals, patient education strategies, discharge timeframes and discharge service requirements
were discussed and implemented. Additionally, ‘family meetings’ were conducted frequently which
allowed for the team to take into consideration the needs of primary carers – an assessment of
duplication of work and, subsequently, of staff workloads (Bynon, et al, 2008). Furthermore, the
overlapping of competences amongst these health care professionals (Satin, 1994) acts to increase the
flexibility of roles and work practices. This gives interdisciplinary teams an advantage over their
independently practicing colleagues in terms of adaptability in the workforce and, again, time- and
cost-efficiency.
An example of such efficiency on CGMC’s aged care ward was the collaborated approach to the
use of interpreters. As necessary, an interpreter would be booked for a time convenient to several
disciplines that required this service. Then, professionals would either see the patient with the
interpreter all together, or visit consecutively, giving verbal handovers to team members to reduce
overlap of patient questioning. Not only did this maintain good communication with the team, it also
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reduced costs of multiple interpreter visits and, moreover, reduced the frustration of repetition for the
patient.
This issue of patient satisfaction is increasingly pertinent in today’s society where there is an
evident trend for health care to be offered as a commodity for sale and for patients to be viewed more
as customers, vying for the best deal (Ife, 1997, as cited by Gardner, 2006) Likewise, health care
consumers are more educated and want to know that they are receiving the best possible treatment
reflecting the latest research. Appreciation and utilization of other team members’ knowledge and
resources enables interdisciplinary teams to keep abreast of new research and provide evidence based
Noted on student placement, the practitioner/therapist with the predicted greatest input into a
patient’s effective discharge would assume the role of ‘case manager’ for that patient. As the role was
shared around, this practice reduced the potential for dominant hierarchical behavior amongst staff and
fostered greater respect for all disciplines (Trede & Smith, n.d., as cited in Higgs, Ajjawi, McAllister,
Trede & Loftus, 2008). Spreading the ‘case manager’ workload maximized each team member’s
Of course, ‘team work’ is not often synonymous with easy and this theme of hierarchy in teams
is a common cause of conflict (Higgs, et al, 2008). Differences in philosophies, whilst being
beneficial in enhancing creativity of care, can also cause tension when deciding on best care - an issue
further compounded by lack of consistency in language and terminology used by different disciplines
(Robertson, Martin & Singer, 2003). Yet, the benefits of collaborative practice far outweigh the
struggles in organisational dynamics (Turner, Ireland, Krenus & Pointon, 2008) and thus various types
of team work training are becoming increasingly available in the health care setting and through
tertiary study.
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Whilst interdisciplinary health care practice was pioneered in the early 1900s (Baldwin, 1996),
it was not until the 1960s that interest in this practice grew (Drinka & Clark, 2000). The recent
investment in interdisciplinary practice has coincided with an era that sees the Australian Government
working to create ‘systems of health care delivery that provide the best care to the most people at the
least cost’ (Drinka & Clark, 2000, p.xv). As such, national health policies have evolved.
At a Macro-policy level, a trend towards developing a national framework for action can be
noted in the government’s attempts to address specific health issues (Taylor, Foster & Fleming, 2008).
This devised framework addresses the current increase in prevalence of chronic conditions in Australia
and the increasing complexity of social and environmental factors underpinning development of
contribution to Australia’s burden of illness and injury include asthma, cancer, diabetes, cardiovascular
disease, arthritis and mental health (Taylor et al, 2008). These are rarely the result of a single cause
and each condition presents sufferers with a plethora of treatment options. Thus, policies that address
NHPA, such as the National Chronic Disease Strategy 2005, stress the importance of an
It must be noted that the increasing presence of chronic disease is most prevalent in socio-
economically disadvantaged sectors of our population (NHPAC, 2006). As such, some reforms in the
financing of health care provision proposed by the Australian Government may in fact lead to further
inequalities in service reception (Taylor et al, 2008). As suggested by Taylor et al (2008, as cited
Baum et al, 2009, p.77), ‘policies are supporting a stronger user-pays system whereby capacity to pay
is an important determinant of access to health care.’ Tackling this obstacle has further highlighted
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the importance of interdisciplinary practice. Negotiating inequality relies heavily on the use of ‘front-
line discretion’ (Taylor et al, 2008) by health care workers to conduct their work in a way that evenly
distributes resources and services (Lipsky, 1980, as cited by Taylor et al, 2008). For example, private
practitioners who actively seek out and work together with professionals from publicly funded health
care services may help in the development of treatment plans that offer greater financial affordability
Further to the issue of policy changes in funding is the increasing pressure on health care providers
to meet more defined and often smaller budgets as a result of the changing structure and distribution of
the Australian health workforce (Australian Health Ministers Conference (AHMC), 2004). The
number of skilled health care professionals is declining (AHMC, 2004) and the population is aging.
Thus the supply of health care professionals and funding across care facilities will be increasingly
stretched to match health care demand. In response, research by Cowan et al (2006), suggests that
thorough collaborative efforts of disciplines in discharge planning effectively reduces length of stay,
decreased patient readmissions to hospital and improved hospital profits when compared to other care
management strategies.
Nonetheless, it must be noted that there have been several adjacent changes in funding policy that
have enhanced the potential for various health disciplines to work together. One such example is new
Medicare initiatives for allied health workers, providing greater access to a wider range of health
services for consumers (Taylor et al, 2008). Another example is the trend towards increased funding
for primary care teams, rather than individual health care professionals, like is evident in the ‘Practice
Incentive Program’ recently introduced in Australia (Young, Gunn & Naccarella, 2008).
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Clearly, the discussed benefits of interdisciplinary professional practice and their impending
relevance in the future have been noted by all levels of parliament as further educational investments in
this area have ensued. Integrating interdisciplinary practice at the tertiary level means that new
graduates in health care professions are well equipped with a high level of skill in communicating and
working effectively with others possessing different norms and conventions to themselves (Cox,
Patterson, Lee & Rahgeb, 2008). Recent personal experience of such team work training at university
enabled a greater understanding of, and appreciation for, other health disciplines but also highlighted
the importance of practising teamwork skills. In reflection, challenges arose when recognising
personal limitations in knowledge and realising that other members of the group were better equipped
to respond to questions at hand. Similarly, delegation of work when partaking in a group ‘leadership’
role was challenging due primarily to differences in individual work standards. It took weeks of
regular group work to recognise that equal allocation of tasks produced a better quality of collaborated
work, in the most time and effort efficient manner. Evidently, skills obtained through team work
education increase a new graduate’s flexibility and adaptability upon entering the workforce (Cox et al,
2008), both traits NHWSF is striving to enhance within the Australian health care system.
Thus, a collaborative approach to health care surely allows for better communication among
health providers, optimizes staff participation in clinical decision making and fosters respect for the
Practice Research Group, 2008). At best, it enables the implementation of health interventions,
tailored to a patient’s needs and desired goals. Moreover, interdisciplinary professional practice not
only accommodates, but embraces cultural and political influences affecting Australian health care
today (Trede & Higgs, 2003). This, combined with a patient-centred approach to health care, appears
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to best meet the needs of the Australian community today and is necessary for the sustainability of
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