Multidisciplinary Team Work

Running head; MULTIDICIPLINARY TEAM WORK MULTIDICIPLINARY TEAM WORK Name of the student Name of the university Author notes 2 MULTIDICIPLINARY TEAM WORK MULTIDICIPLINARY TEAM WORK Introduction Multidisciplinary team work is one of the significant and effective care approaches in the context of providing palliative or end -life care. A multidisciplinary team (MDT) generally made up with the collaboration of several healthcare experts from many dis ciplines and professions that coordinate to provide the best possible treatment to a patient. Because of the multiple dimensions required in providing proper care for Palliative Patients , most sectors of healthcare today work as multidisciplinary teams, however palliative care lends itself especially well with this approach (Hurst et al., 2016) . In this paper the discussion is about multidisciplinary team work and palliative care. This paper will review eight different papers and gather different findings regarding this topic. Search strategy Search strategy is one of the important parts in review paper, selecting appropriate words is a vital factor, appropri ate search strategy will provide appropriate results (Ali & Usman, 2018) . Hence, in this context some significant as well as relevant search terms have been used such as palliative care, multidisciplinary care approach , multidisciplinary team work. The search keywords were the above -mentioned terms. When searching the database, the terms "AND" and "OR" are utilized. PUBMED, ProQuest and Java Network, were the three databases those has been used in this review procedure. Without applying the inclusion and exclusion criteria more than 50 papers appeared. However, 8 relevant papers were bringing down from the databases and the best matches were chosen. Some inclusion and exclusion criteria have been used while selecting the articles such as papers should rel ated to palliative care, Multidisciplinary Team 3 MULTIDICIPLINARY TEAM WORK Work is involved, the articles written in English and published in between 2016 to 2021. And the articles related to other care approaches instead of palliative care were excluded, articles written in other l anguages and more than 5 -year publications were excluded. Key words Inclusion criteria Exclusion criteria Palliative care Language - English Other languages Multidisciplinary care Topic – palliative care and multidisciplinary care work Other care approaches Multidisciplinary team work Year of Publication – 201 R J 2021 Published before 201 R Articles derived from the search to be used for literature review Fernando, G. V. M. C., & Hughes, S. (2019). Team approaches in palliative care: a review of the literature. International journal of palliative nursing , 25 (9), 444 - 451. https://www.magonlinelibrary.com/doi/abs/10.12968/ijpn.2019.25.9.444 Silva, A. F. D., Issi, H. B., Motta, M. D. G. C. D., & Botene, D. Z. D. A. (2015). Palliative care in paediatric oncology: perceptions, expertise and practices from the perspective of th e multidisciplinary team. Revista gaucha de enfermagem , 36 , 56 - 62. https://www.scielo.br/j/rgenf/a/v7mLR86DTXnKrLCzJ9Cddsx/?lang=en Verberne, L. M., Schouten -van Meeteren, A. Y., Bosman, D. K., Colenbrander, D. A., Jagt, C. T., Grootenhuis, M. A., ... & Kars, M. C. (2017). Parental experiences with a paediatric 4 MULTIDICIPLINARY TEAM WORK palliative care team: a qualitative study. Palliative medicine , 31 (10), 956 - 963. https://journals.sagepub.com/doi/full/10.1177/0269216317692682 Knights, D., Knights, F., & Lawrie, I. (2020). Upside down solutions: palliative care and COVID -19. BMJ supportive & palliative care .https://spcare.bmj.com/content/early/2020/07/17/bmjspcare -2020 -002385.abstract Kilonzo, I., Lucey, M., & Twomey, F. (2015). Implementing outcome measures within an enhanced palli ative care day care model. Journal of pain and symptom management , 50 (3), 419 -423. https://www.sciencedirect.com/science/article/pii/S0885392415001852 Herrmann, A., Carey, M. L., Zucca, A. C., Boyd, L. A., & Roberts, B. J. (2019). Australian GPs’ perceptions of barriers and enablers to best practice palliative care: a qualitative study. BMC palliative care , 18 (1), 1 - 14. https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904 -019 -0478 -6 Smallwood, N., Thompson, M., Warrender -Sparkes, M., Eastman, P., Le, B., Irving, L., & Philip, J. (2018). Integrated respi ratory and palliative care may improve outcomes in advanced lung disease. ERJ open research , 4(1). https://openres.ersjournals.com/content/4/1/00102 -2017.short Mendis, R., Soo, W . K., Zannino, D., Michael, N., & Spruyt, O. (2015). Multidisciplinary 5 MULTIDICIPLINARY TEAM WORK prognostication using the Palliative Prognostic Score in an Australian cancer center. Palliative Care: researCh and treatment , 9, PCRT - S24411. https://journals.sagepub.com/doi/full/10.4137/PCRT.S24411 Findings As mentioned in the above portion that after using those relevant key term 8 different articles have been selected for this discussion or review. Hence after reviewing these articles, it has been possible to summarize three key issues from all of them. the key issues are barriers and conflicts of multidisciplinary team work in palliative care, coordination of care and holistic care planning. Multidiscipli nary team work is one of the effective care approaches, in order to provide appropriate care to the patient, specifically in the context of end -life care or palliative care . However, after going through these papers it has been found that the team members generally faced several types of barriers and conflicts at the time of providing care (Wysham et al., 2017) . Because of the fragmentation of care, this method is seen to have practical limits. In addition, the team also get affected emotionally through th e palliative care specifically in the case of pediatric palliative care. Then another issue is about coordination, as it is known to all that several experts are involved in these type of care approaches, hence proper coordination is one of the important f actors in order to provide appropriate and hazard less care. Multidisciplinary teams (MDTs) are a system for organizing as well as coordinating health -care services to address the requirements of people with complicated medical conditions. Improper coordin ation may cause several complications or issues in their care procedure. The teams gather the knowledge and abilities of many experts to 6 MULTIDICIPLINARY TEAM WORK collaboratively assess, plan, a s well as manage care. Coordination between team member is as important as coordination with patient and patient family members. A holistic care generally refers to the type of care that include physical, emotional, psychological as well as spiritual needs of the patient. Holistic care planning is the basic intention of multidisciplinary care approach, at the same time patient at their end life care or palliative care often need a proper holistic care (Abel & Kellehear, 2016) . After going through these selected papers, it has been found in most of the cases that multidisciplinary care approaches play a significant role in palliative care, however in some cases improvements were needed. Author’s names/years Key issue 1: barriers and conflicts of multidisciplinary team work Key issue 2: coordination of care Key issue 3: Holistic care planning 1 Fernando & Hughes, 2019  Fragmentation of car e  No coordination issue 2 Silva, Issi, Motta, & Botene , 2015  extreme suffering  No coordination issue 3 Verberne et al, 2017  No such barriers found  coordination within team member  coordination 7 MULTIDICIPLINARY TEAM WORK with patient and family 4 Knights, Knights & Lawrie, 2020.  No such barriers found  No coordination issue  Improving quality of life  Spiritual support 5 Kilonzo, Lucey & Twomey , 2015  Improper tools  Poor model of care  No coordination issue 6 Herrmann et al, 2019  No such barriers found  complicated and frequently emotional nature of doctor -family interactions  shortage of evidence to guide treatment  the need to discuss roles and responsibilities 8 MULTIDICIPLINARY TEAM WORK within the healthcare team 7 Smallwood et al, 2018  No such barriers found  No coordination issue  Accessible,  Sustainable  Adaptable 8 Mendis et al, 2015  No such barriers found  No coordination issue  Single physician survival prediction Discussion Barriers and conflicts of multidisciplinary team work Multidisciplinary team work consists some limitations or barriers. This approach also faced several conflicts in order provide palliative care to the patient (Verberne et al., 2018) . According to Fernando & Hughes, (2019), model of teamwork is one of the significant factors to provide effective and adequate care. Model of teamwork depends on team structure. However, in some case the team structure becomes of the biggest barriers in providing care. In a hypothetical multidisciplinary team, individual duties are well specified, each expert delivers treatment in solitude, rather than engaging with other members of the team. Because of the dispersion of care, this method is seen to have practical limits. As per Kilonzo, Lucey & Twomey , (2015 ), improper model of care and insufficient tools may become the barriers, however, using some significant tools and effective model of care can able to reduce conflicts and barriers in multidisciplinary 9 MULTIDICIPLINARY TEAM WORK teamwork in the context of palliative care. In some cases, team members often face several types of conflicts in this care process. The author Silva et al, (2015), focused on pedi atric palliative care and multidisciplinary team work. They stated in their paper that these multidisciplinary professionals do not acknowledge the traditional attitude of "don't get involved" when they encounter moments of extreme suffering, emotional as well as work -related needs, and fully comprehend that caring for children in such a complex situation requires more than scientific knowledge; it also requires an act of humanity and kindness. They often get emotionally affected through this care procedure . coordination of care Coordination of care is very important while it is about providing care through a team. A team consist several members, hence coordination between members is one of the important things, in addition coordination with patient or pati ent’s family is also play a vital role in palliative care. In this context, according to the study of Verberne et al, (2017), it has been found that, that parents have seen the pediatric palliative care teams (PPCT) as a source of assistance and that the PPCT is becoming increasingly valuable. The practical help, process -related features, and the PPCT members' reliable and sensitive attitude were all highly praised by parents. These three factors are most likely to blame for the reported outcomes, such as better child and family quality of life as well as competent pediatric palliative care . Hence, it can be stated that appropriate coordination plays a significant role in improving quality of life as well as care procedure. In this context, another study which was conducted by Herrmann et al, (2019), found several communication barriers in the context of providing palliative care such as the complicated and frequently emotional nature of do ctor -family interactions, a shortage of evidence to guide treatment; and the need to discuss roles and responsibilities within the healthcare team, GPs 10 MULTIDICIPLINARY TEAM WORK acknowledged problems with palliative care provision. However, this study contributes to the understandi ng of how to overcome barriers to palliative care provision in general practice and assist patients receive the best care possible at the end of life. The findings imply that academics and policymakers should take a holistic approach to enhancing palliativ e care delivery, addressing the wide range of obstacles and facilitators highlighted in this study. A t the end this paper suggests some effective strategies through with communication of care can improve among them one of the significant strategies was cle arly dividing roles and responsibilities among multidisciplinary team member to provide appropriate palliative care. Holistic care planning A multidisciplinary care team generally consist several experts from several disciplines, such as health care professional (doctors, nurses, psychologist, physiotherapist, nutritionist, dietitian and all), social workers as well as others (Fletcher, 2016) . All of these experts form a team and divided their duties among them and provide care as per their knowledge and expertise, and share their findings and knowledge between team members for better outcome. According to the nature of care procedure of multidisciplinary team work, the main aim of this group is to provide a holistic care to the patient. patient at the ir end stage of life need a complete or holistic care. In this context, according to the study of Knights, Knights & Lawrie, (2020 ), it has been found that many people who are suffering at their end stage of life in this covid -19 pandemic need a proper hol istic care. It is critical to take a holistic approach to the care of patients, family, and coworkers, taking into account physical, psychological, social, or spiritual problems. Palliative care professionals must democratize this multidisciplinary care ap proach now more than ever by not just practicing holistic healthcare but also pushing the health system as a whole to do so. Multidisciplinary team work has a huge role in enhancing quality of life of those patients who 11 MULTIDICIPLINARY TEAM WORK are suffering at their end stage of life by providing holistic care. Such as according to Smallwood et al, (2018), it has been found that, Improved end -of-life care was linked to integrated respiratory and palliative care. Integrated care services must address local health service requiremen ts and investigate possibilities to create relationships with primary care, in addition to being accessible, sustainable and adaptable, multiprotection and multidisciplinary workforce capable of meeting the palliative care demands of patients with advanced nonmalignant respiratory illness. In addition, another study which was conducted by Mendis et al, (2015), stated that, it is conceivable to use a multidisciplinary team approach to prognostication in normal clinical practice with end life care , and it may be able to replace single physician survival prediction inside the PaP score without compromising its accuracy. Conclusion This is a review paper, this paper covered eight relevant journal articles which is related to the topic of palli ative care and multidisciplinary team work. These papers have been selected by using a proper search strategy including inclusion and exclusion criteria. After going through this 12 MULTIDICIPLINARY TEAM WORK review paper, it can be concluded that multidisciplinary team work plays a si gnificant role in order to provide palliative care. A multidisciplinary care team generally consist several experts from several disciplines such as doctors, nurses, psychologist, physiotherapist, nutritionist, dietitian, social workers as well as others. Hence, it can be stated that this care approach may play a significant and positive role in palliative care. Also, there are some barriers and conflicts that the team members may face in this procedure . However, this approach has several significant benef its and helping patients at their end stage of life by providing them a holistic care. However, in future further researches are needed in this particular topic in order to get better results. 13 MULTIDICIPLINARY TEAM WORK References Abel, J., & Kellehear , A. (2016). Palliative care reimagined: a needed shift. BMJ Supportive & Palliative Care , 6(1), 21 -26. https://spcare.bmj.com/content/6/1/21.short Ali, N. B., & Usman, M. (2018). Reliability of s earch in systematic reviews: Towards a quality assessment framework for the automated -search strategy. Information and Software Technology , 99 , 133 - 147. https://www.scie ncedirect.com/science/article/abs/pii/S0950584917304263 Fernando, G. V. M. C., & Hughes, S. (2019). Team approaches in palliative care: a review of the literature. International journal of palliative nursing , 25 (9), 444 - 451. https://www.magonlinelibrary.com/doi/abs/10.12968/ijpn.2019.25.9.444 Fletcher, J. (2016). Spiritual screening in community -based palliative care by the multidisciplinary team. In Spirituality across Disciplines: Research and Practice: (pp. 229 -241). Springer, Cham. https://link.springer.com/chapter/10.1007/978 -3-319 -31380 - 1_18 Herrmann, A., Carey, M. L., Zucca, A. C., Boyd, L. A., & Roberts, B. J. (2019). Australian GPs’ perceptions of barriers and enablers to best practice palliative care: a qualitative study. BMC palliative care , 18 (1), 1 - 14. https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904 -019 -0478 -6 https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904 -018 -0274 -8 Hu rst, A., Jobidon, E., Prier, A., Khaniyev, T., Rennick, C., Al -Hammoud, R., ... & Bedi, S. (2016, June). Towards a multidisciplinary teamwork training series for undergraduate 14 MULTIDICIPLINARY TEAM WORK engineering students: Development and assessment of two first -year workshops. In 2016 ASEE Annual Conference & Exposition . https://peer.asee.org/toward s-a- multidisciplinary -teamwork -training -series -for -undergraduate -engineering -students - development -and -assessment -of-two -first -year -workshops Kilonzo, I., Lucey, M., & Twomey, F. (2015). Implementing outcome measures within an enhanced palliative care day care model. Journal of pain and symptom management , 50 (3), 419 -423. https://www.sciencedirect.com/science/article/pii/S0885392415001852 Knights, D., Knights, F., & Lawrie, I. (2020). Upside down solutions: palliative care and COVID -19. BMJ supportive & palliative care .https://spcare.bmj.com/content/early/2020/07/17/bmjspcare -2020 -002385.abstract Mendis, R., Soo, W. K., Zannino, D., Michael, N., & Spruyt, O. (2015). Multidisciplinary prognostication using the Palliative Prognostic Score in an Australian cancer center. Palliative Care: researCh and treatment , 9, PCRT - S24411. https://journals.sagepub.com/doi/full/10.4137/PCRT.S24411 Silva, A. F. D., Issi, H. B., Motta, M. D. G. C. D., & Botene, D. Z. D. A. (2015). Palliative care in paediatric oncology: perceptions, expertise and practices from the perspective of the multidisciplinary team. Revista gaucha de enfermagem , 36 , 56 - 62. https://www.scielo.br/j/rgenf/a/v7mLR86DTXnKrLCzJ9Cddsx/?lang=en Smallwood, N., Thompson, M., Warrender -Sparkes, M., Eastman, P., Le, B., Irving, L., & Philip, J. (2018). Integrated respiratory and palliative care may improve outcomes in advanced lung disease. ERJ open research , 4(1). https://openres.ersjournals.com/content/4/1/0 0102 -2017.short 15 MULTIDICIPLINARY TEAM WORK Verberne, L. M., Kars, M. C., Schepers, S. A., Schouten -van Meeteren, A. Y., Grootenhuis, M. A., & van Delden, J. J. (2018). Barriers and facilitators to the implementation of a paediatric palliative care team. BMC Palliative Care , 17 (1), 1 -8. Verberne, L. M., Schouten -van Meeteren, A. Y., Bosman, D. K., Colenbrander, D. A., Jagt, C. T., Grootenhuis, M. A., ... & Kars, M. C. (2017). Parental experiences with a paediatric palliative care team: a qualitative study. Palliative medicine , 31 (10), 956 - 963. https://journals.sagepub.com/doi/full/10.1177/0269216317692682 Wysham, N. G., Hua, M., Hough, C. L., Gundel, S., Docherty, S. L., Jones, D. M., ... & Cox, C. E. (2017). Improving intensive care unit -based palliative care delivery: a multi -center, multidisciplinary survey of critical care clinician attitudes and beliefs. Critical care medicine , 45 (4), e372. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344777/