Interprofessional Colaboration In the Medical Setting

Acute Care Hospital Setting Sudden decline in medical and functional status Goal is to stabilize patient Typically address swallowing

Inpatient Hospital Setting Intense rehab services, often 6 days/wk Average stay is 20 days Goal of achieving highest possible quality of life 1:1 and group treatment Co-treatment

Outpatient Building could be on-site or off-site See a range of clients with varied etiologies Typically referred by physician Could see adults, peds, or a combination

Skilled Nursing Facilities (SNF) Could be long-term or temporary Varied caseload Have become more ill than in the past

What is Interprofessional Collaboration? Continuous interaction, coordinated efforts, and knowledge sharing among health care professionals “Enhanced Collaboration” Each professional’s contribution is valued equally

Why is interprofessional collaboration important? We can better serve our patients To ensure the right person is delivering the care

Who do we collaborate with? Occupational Therapists (OT) Physical Therapists (PT) Respiratory Therapists (RT) Dieticians Nurses CNAs Physicians (PCP, Radiologists, GE, ENT) Social Workers Case Managers Interpreters Family and/or Caregivers

Occupational Therapists Provide training in self-care and home management activities (ADLs). Remediate upper-extremity weakness and/or abnormal muscle tone Provide wheelchair assessment and management

OT cont. Management of feeding, eating, and swallowing conditions Sensory integration therapy

How we collaborate? Positioning or accessibility needs Feeding and swallowing Cognition during ADLs Sensory needs Communication support

Physical Therapists Therapeutic exercise and functional training “Manipulate" a joint or massage muscle Help prevent the loss of mobility Train patients in postsurgical orthopedic protocols

How we collaborate Diet/liquid recommendations Cognition during gross motor tasks Communication needs

Respiratory Therapists Analyze breath, tissue, and blood specimens to determine levels of oxygen and other gases. Manage ventilators and artificial airway devices for patients who can’t breathe normally on their own.

How we collaborate Signs of aspiration pneumonia Explaining management of COPD Tracheostomy care and treatment Swallowing for patient on noninvasive ventilation Identifying PVFM

Dieticians Provide medical nutrition therapy Assess patients' nutritional needs, develop and implement nutrition programs, and evaluate and report the results. May manage food service department

How we collaborate Dieticians may encounter patients at risk for dysphagia Problem-solving patient feeding issues

Nurses Perform physical exams and health histories Administer medications, wound care, etc Interpret patient information and make critical decisions Direct and supervise care delivered by LPNs and CNAs

How we collaborate Level of alertness Any change in patient status Medication needs Communication needs

CNAs Work under the direction of an LPN or RN Bathe and dress patient Oral care Feed patient Toileting assistance Assist with range-of-motion exercises Turning and positioning bedridden patients regularly

How we collaborate Aspiration precautions during/after PO Oral care needs Communication needs Cognition during ADLs

Doctors PCP: Contact for continuing care Radiologist: specializes in the dx and tx of disease and injury by using medical imaging technologies GE: Specializes in diseases of the digestive system Otolaryngologist: medical and surgical management and treatment of patients with diseases and disorders of the ear, nose, throat (ENT), and related structures of the head and neck.

How we collaborate Radiologist present for MBSS May get referrals from doctors May recommend referrals to doctors

Social Workers and Case Managers Help patients and their families understand a particular illness and work through emotions of a dx Provide counseling about the decisions that need to be made Help client to find resources and facilitates connection with services Advocates on behalf of a client to obtain needed services

How we collaborate Counseling of difficult issues Coordination of discharge planning, including client services and needs

Interpreters A communicator liaison between non-English speaking patients and hospital staff.

How we collaborate During evaluation and treatment Necessary that client understands POC and provides their consent

Family and/or Caregivers Often present during hospital stay Want increased contact with therapists and increased involvement in therapy activities.

How we collaborate Support cog or comm strategies Diet/liquid recommendations and eventual preparation

Benefits and Challenges of Interprofessional Collaboration Improved patient outcomes Enhanced provider satisfaction More effective utilization of resources Challenges: Billing during co-treatment Ensuring you stay within your scope of practice