How to work in multi-disciplinary teams

How to work in multi-professional teams

Like families, multi-disciplinary teams can work brilliantly together – or be totally dysfunctional. It’s hardly surprising that when you assemble a diverse group of people with varied skills into a team, things don’t always go smoothly. But multi-professional teams are a fact of life in social work, with integration between professions set to get ever closer. So how can teams work together efficiently?

Ways of creating resilient multi-professional teams were recently explored at a workshop held at St Christopher’s hospice in London.

Ideas from presentations by Malcolm Payne, director of psycho-social and spiritual care at St Christopher’s; Maggie Draper, specialist palliative care social worker; and Dr Anne Garry, consultant in palliative medicine, both at Selby and York Primary Care Trust, are summarised below.

1.  Define roles and boundaries

Members of a multi-professional team including social workers, nurses, psychiatrists, and teachers will have different training, ways of working and culture. Social care, health and education are all sectors which have undergone huge change, restructuring and reorganisation. Evolving roles and boundaries consequently affect how professionals work together and can cause confusion. Everyone needs clarity on their own role and to be clear about what other team members do.

2. Be aware of power dynamics

Asserting your professional identity over colleagues can be threatening and excluding and this needs to be addressed.
Who has the most power within multi-disciplinary teams? Lone social workers in palliative care teams can feel marginalised because they work in medical settings (hospices and hospitals).
Are certain team members competing for control? Do some have more status than others?
Do staff in multi-professional teams share a common language? Social work, health, and education all have their own jargon, which can be alienating.

3. Taking decisions

How are decisions made in teams? Who has overall responsibility? Does everyone want responsibility? Do some seek refuge in other people’s decision-making?
Team members must learn to value each other’s contributions, look at how the group communicates and be aware of making judgements and holding prejudices.
Emotions and egos should not get in the way during meetings and discussions. Any action to be taken should be a shared vision owned by all team members.

4. Different professionals have different views

Service users, especially “difficult” ones tend to cause friction between professionals, who may have different views on best practice.
Social workers in a multi-professional team can have different loyalties and priorities to colleagues and varying views on appropriate care. Service users can manipulate professionals and play off one against each other. Demanding service users can expose flaws in the way professionals work together.

5. Input from service users

Professionals might like to consider whether the service user should be considered a member of the multi-disciplinary team. Put yourself in the shoes of someone who has a whole team of professionals discussing their welfare. Wouldn’t you like the chance to contribute? Don’t underestimate the value of listening to service users.
Bear in mind that service users who articulate their needs strongly can make some staff feel threatened.
Are some team members more likely to take notice of easy-going service users, while the demanding clients find it harder to get attention from staff?

Info on education and training courses at St Christopher’s hospice in London http://www.stchristophers.org.uk/page.cfm/Link=382/t=m/goSection=8

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