1. Interdisciplinary Care PO 007

2. Learning Objectives
The physical therapist technician will learn how to interact with other health care professionals by:
Defining Interdisciplinary care
Identifying the various members of the multidisciplinary team
Describe the roles of the team members
Define medical rounds and PT role in rounds
Understand when to consult with other health care professionals about patient care

3. Learning Objectives Continued . . .
Understand when mandatory reports to other health care professionals on patient status are required
Understand the difference between medical and administrative issues, and which team members are responsible for each
Define community partners and identify those that apply to physical therapy
Be able to access help from community partners when required

4. Interdisciplinary One or more disciplines working collaboratively
Members of several professions providing interventions independently, but also collaborating with each other to ensure optimal outcomes
This approach involves professionals operating within the boundaries of their profession towards discipline-specific goals, while recognizing the important contribution from other disciplines

5. Interdisciplinary Teams
An interdisciplinary team is a group of practitioners from different professional backgrounds who work together to achieve jointly established goals for patients/clients
Interdisciplinary teams provide interprofessional collaborative practice:
The interaction of two or more health practitioners from different professional backgrounds to deliver the highest quality of services to patients/clients

6. Members of the Team
The members of an interdisciplinary team vary but can include:
The patient
Doctor
Nurse/nursing assistant
PTT
Pharmacist/pharmacy technician
Physician assistant
Dentist/dental technician
Mental health professionals
Bmet
Medical logistics
Family members/care givers

7. An Effective Team Essential elements for effective teams:
Shared goals: reasons to work together
Interdependence: recognition of individual roles in the achievement mutual goals
Commitment: working together leads to more effective decisions
Accountability: shared commitment as a functioning unit

8. PTTs and Interdisciplinary Teams
When PTTs are members of a interprofessional team providing services for the patient/client, they will ensure that:
Relevant information is sought and communicated promptly and clearly within the team
A system is in place for written communication with other members of the team
the physical therapy goals comply with the team goals

9. PTTs and Interdisciplinary Teams Continued . . .
Policies exist for referral to other professionals, discharge, and transfer of patients/clients
Team members participate in case conferences, rounds, individual patient/client care meetings, discharge planning, and the preparation of collaborative patient/client records

10. Medical Rounds
The medical problems and treatment of a particular patient are presented to an audience consisting of doctors, residents and other health care professionals
Are an important teaching tool and ritual of medical education and patient care
Allow healthcare professionals keep up to date in important evolving areas which may be outside of their core practice

11. Medical Rounds Continued . . .
Currently, medical rounds take place in NMH on a weekly basis and are mainly attended by doctors and nurses
It would be beneficial for PTTs to become involved in rounds as they are members of the interdisciplinary team, and could benefit from the information and education provided
This is something for future PTTs to establish as part of promoting the role of physical therapy in interdisciplinary patient care

12. Consulting With Team Members
It is important for the provision of care that each discipline not work independently, but always recognize the team approach to patient care
Regular consultation with appropriate health care professionals is essential
In order to consult properly with other health care professionals, it is important to understand each professions role

13. Collaboration
The PTT collaborates with other professionals as appropriate
The PTT shall be aware of the qualifications and roles of other professionals involved in comprehensive patient/client care/management, and practice in collaboration with them to provide quality services

14. Collaboration Continued . . .
PTT collaboration when appropriate:
Uses a team approach to the management of patients/clients
Provides instruction to patients/clients and families
Ensures professional development and continuing education

15. Defining Roles
Although the responsibility for various aspects of patient care are not always clearly defined, and there is overlap, the following can be used as general guidelines:
Doctors:
Usually lead patient care and coordination
Provide diagnosis and outline the treatment plan
Nurse/nursing assistants:
Responsible mainly for implementation of inpatient care by facilitating treatment plans and liaising with all team members

16. Defining Roles Continued . . .
Pharmacist/pharmacist techs:
Pharmaceutical counseling and management
Physician assistants:
May be involved, especially in more regional locations where there may not be a physician
Dentist/Dental techs:
May be involved if the patient has facial or dental injuries or conditions
Social worker/mental health:
Responsible for mental health conditions
Often works with the family in facilitating support for the patient when they return home

17. Defining Roles Continued . . .
Bmet:
Responsible for the maintenance and repair of health care equipment
Medical logistics:
Responsible for provision of supplies needed for patient care
Family members/care givers:
Act as support network for patient
The patient

18. When To Consult?
It is absolutely necessary to consult with the team lead (usually the doctor) when:
There is a decline in patient status
There are contraindications to treatment outlined in the referral or treatment plan
The patient presents with new signs or symptoms that are not related to the condition for which they were referred to PT
The patient has had a new injury

19. Why To Consult Continued . . .
Other reason PTTs may consult with various health care professionals:
There is a concern with the patient or their care that is out of the scope of the PTT
The patient requires treatment from another provider that will impact the PT treatment
The PTT has a concern about an issue that is out of their scope, but has an impact on PT treatment
The patient expresses concerns about treatment received from another provider
There are administrative issues with patient care

20. Clinical vs. Administrative
When consulting with the interdisciplinary team, it is important to understand the difference between clinical and administrative issues:
Clinical:
Deals with the direct care required or provided
eg. pain levels, weight-bearing status, infections, etc.
Administrative:
Deals with the organization, policy, procedures, resources, etc., of the care provided
eg. patient scheduling, payment and insurance, equipment concerns, employment and chain of command issues

21. Clinical vs. Administrative Continued . . .
It is important that when consulting with members of the interdisciplinary team that the right person is consulted about the right issues
Clinical matters are to be address by clinicians
i.e. doctors, nurses, senior PTTs, etc.
Administrative matters are to be addressed by administrators
i.e. chain of command, med log, Bmet, etc.

22. Community Partners
An entity, person or organization that serves the interests of similar clients
Connections between and among people and groups to share interests and concerns, and create visions for the future
Often governmental or international provision of assistive services to people in need

23. Community Based Rehabilitation (CBR)
A community development strategy for the rehabilitation, equalization of opportunities, and social integration of all people with disabilities
Implemented through the combined efforts of disabled people themselves, their families and communities, and the appropriate health, education, vocational and social services

24. CBR Continued . . .
The use of CBR is essential in Afghanistan and in the ANA, as the health care system is still evolving and is not yet self-sufficient
There are several community partners that are crucial to the provision of PT services
Relationships should be established with the appropriate community partners to ensure the best possible PT care is provided to patients

25. PT Community Partners
The following are useful community partners for PTTs in the ANA:
Physiotherapy Training Institute of Kabul (PTI)
International Committee of the Red Cross (ICRC)
World Confederation of Physical Therapy (WCPT)
The World Health Organization (WHO)

26. Engaging Community Partners
It is important that PTTs use community partners appropriately
The PT chain of command should be notified when community partners are required, and should continue to be informed about their involvement
Since there is currently no PT regulatory body in Afghanistan, reliance on international PT organizations is essential to guide PT care, standards and guidelines

27. Summary
Interdisciplinary care requires all health care professionals to work together to reach common goals
The patient should be at the center of all care
Team members must work within their respective scopes of practice and seek guidance from other professionals when required
Community partners should be utilized to ensure the best PT care is available

28. Questions?

29. Comprehension Check What constitutes an interdisciplinary team?
Under what circumstances is it absolutely necessary for a PTT to contact the physician/ interdisciplinary team leader about a patient?
Under what other circumstances should a PTT consider consulting another health care professional?
How do clinical and administrative issues differ?
What is Community Based Rehabilitation (CBR)?

30. Answers
A group of practitioners from different professional backgrounds who work together to achieve jointly established goals for patients/clients
When:
There is a decline in patient status
There are contraindications to treatment outlined in the referral or treatment plan
The patient presents with new signs or symptoms that are not related to the condition for which they were referred to PT
The patient has had a new injury

31. Answers
When:
There is a concern with the patient or their care that is out of the scope of the PTT
The patient requires treatment from another provider that will impact the PT treatment
The PTT has a concern about an issue that is out of their scope, but has an impact on PT treatment
The patient expresses concerns about treatment received from another provider
There are administrative issues with patient care

32. Answers 4. Clinical: Administrative:
Deals with direct patient care required or provided
Administrative:
Deals with the organization, policy, procedures, resources, etc., of the care provided
5. A community development strategy for the rehabilitation, equalization of opportunities, and social integration of all people with disabilities