1: Teams in Health Care

Introduction

There are many different health care professions and many ways professionals may collaborate to enhance the quality of patient care.

Every member of a team brings specialized skills and a unique perspective to the task. Additionally, every profession has a specific code of ethics to which its members must adhere.

As you complete your readings and assignments for the week, consider the advantages and disadvantages of taking a team approach to patient care.

Objectives

This week you will:

• Describe the importance of interdisciplinary teams in health care

• Identify the specific health care professionals involved in a health care team, including their roles and responsibilities

Interdisciplinary Teams

This week, you've examined the rationale, form, and function of an interdisciplinary team in providing health care. As you've seen, members of an interdisciplinary team may come from a variety of professional backgrounds, depending on the needs of the patient, the setting in which care is provided, and the resources available.

To prepare for this Discussion, review the case study on pages 2-4 of your course text.

Initial postings must be 250-350 words (not including references).

CASE STUDY: A 43-YEAR-OLD MOTHER WITH EARLY STAGE BREAST CANCER

Linda Simmons (name has been changed) is a 43-year-old previously healthy woman, and wife and mother of two girls, ages 8 and 10. During the course of her regular breast self-examination, she discovered a suspicious lump in her left breast. She went to her family physician whose examination confirmed the presence of a suspicious mass. Her physician confirmed the diagnosis after Mrs. Simmons obtained a mammogram at the local hospital. Mrs. Simmons was then referred to a surgical oncologist on the staff of a cancer center at a nearby teaching hospital who carried out a surgical biopsy. The biopsy revealed a localized early stage malignancy of the breast. The surgeon immediately brought in a medical oncologist and, together with the occasional involvement of a radiation therapist at the hospital, they developed a tentative treatment plan involving limited breast surgery, medical chemotherapy, and possible follow-up radiation therapy.

Mrs. Simmons was admitted to the hospital and the recommended surgery was carried out. This was followed by a course of chemotherapy over several months that involved regular visits to the medical oncologist's office for administration of the appropriate medication. Because Mrs. Simmons had had previous bouts of clinical depression and was showing signs of a possible repeat episode of depression as a result of her diagnosis and treatment, her family physician referred her to a mental health professional for possible intervention and medical treatment. Because the chemotherapy medicine was quite expensive and her husband's health insurance plan did not pay the full cost of treatment, Mrs. Simmons met with a social worker at the cancer center to see if there might be some way to offset the high costs of the proposed chemotherapy.

Throughout the course of treatment in the hospital and as an outpatient in the medical oncologist's office, Mrs. Simmons developed very close ties with the nurses who participated in various aspects of her care. Indeed, in both settings, Mrs. Simmons came to depend upon the nursing staff members for clinical services and, perhaps more importantly, for personal support and information. She believed that the nursing personnel were the strongest and most sustained durable link in her process of care.

At one point, a clinical pharmacist was consulted because the chemotherapy was having severe side effects of nausea and weakness, and a change of medication dosage was recommended; an additional new medication was ordered to relieve the side effects of the chemotherapy. Also, early in her treatment, Mrs. Simmons had a series of genetic tests to determine whether several specific breast cancer-related genes were present, because their presence or absence might influence the choice of chemotherapy. After discovery that she was positive for the presence of several of these genes, Mrs. Simmons was seen by a genetic counselor who explained the relevance of these findings to her care; this genetic counselor also helped her to review the appropriateness of testing her two daughters for these genes either now or at a later point in their lives.

At the present time, Mrs. Simmons has successfully completed her chemotherapy regime and is being followed as an outpatient by both the medical oncologist and her family physician, with occasional visits to the hospital for laboratory tests and x-rays. Fortunately, both physicians and the hospital maintain electronic medical record systems, but because they are not linked together into a single system, Mrs. Simmons must follow all three systems separately to get a complete picture of her care and prognosis. Her husband's health insurance carrier participates in a breast cancer case management program as well and has an electronic medical record system relating to her insurance-covered care, but Mrs. Simmons has found that less useful than the other three local systems.

• Discussion -

Name two additional types of health professionals that could have been involved in the case.

•Provide a rationale as to why they should have been included.

•In your own words, explain why that professional is important to an interdisciplinary team and what you believe he or she would contribute.
Initial postings must be 250-350 words (not including references).