Palliative Care Interdisciplinary Team model for Clinical Ethics Consultation ASBH
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Interactive workshop presentation exploring the Palliative Care model for Interdisciplinary Team consultation in an application for Clinical Ethics Consultation. Presented at the American Society for Bioethics and Humanities national conference in San Diego, October 17, 2014.
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Palliative Care Interdisciplinary Team model for Clinical Ethics Consultation ASBH
- 1. Palliative Care as a Model S for Interdisciplinary Consult in Clinical Ethics Andi Chatburn, DO, MA Providence Health Care, Spokane WA Medical Director for Ethics Palliative Care Physician #ASBH14 October 17, 2014 10:45-12:15 PM Rm 300A
- 2. Disclosures None! transition
- 3. Objectives S Describe the Palliative Care model for Interdisciplinary Team (IDT) consultation S Apply the IDT model for consultation to Clinical Ethics Consultations
- 4. Applications S Utilize the IDT model for consultation in sample role-play scenarios S Reflect on experience utilizing the IDT model for Clinical Ethics Consultation (CEC)
- 6. Optimal Care
- 7. Characteristics of an IDT S Interdisciplinary teamwork- provides increase complexity of skills and knowledge needed to provide comprehensive care. S No single professional can meet all the complex needs
- 8. Value of an IDT S Shared Goal of a Palliative care IDT: identify and manage suffering among patients and families S Team members are interdependent, meaning they cannot relieve total pain (i.e., spiritual, emotional, physical, psychological) unilaterally, but must rely on teamwork
- 9. Dietician Adapted from capcsd.org Nurse Patient & Caregiver Speech Therapist & PT/OT Physician Chaplain Social Worker
- 10. Dietician Adapted from capcsd.org Nurse Patient & Caregiver Speech Therapist & PT/OT Physician Chaplain Social Worker Pharmacist Music Therapist Dignity Therapy Child Life Specialist Art Therapist Psychologist
- 11. Teams with multiple disciplines S Interdisciplinary Team- a group of health care professionals from diverse fields who work in a coordinated fashion toward a common goal for the patient http://medical-dictionary.thefreedictionary.com
- 12. Nurse Patient & Caregiver Speech Therapist & PT/OT Physician Chaplain Dietician Social Worker
- 13. Paired Consult IDT Social worker Nurse Physician Chaplain Nurse Nurse Physician Physician Social Worker
- 14. Teams with multiple disciplines S Intraprofessional team: a team of professionals who are all from the same profession, such as three physical therapists collaborating on the same case. http://medical-dictionary.thefreedictionary.com
- 15. Patient & Caregiver Physician Physician Physician
- 16. Teams with multiple disciplines S Multidisciplinary team: a team of professionals including representatives of different disciplines who coordinate the contributions of each profession, which are not considered to overlap, in order to improve patient care http://medical-dictionary.thefreedictionary.com
- 17. Nurse Patient & Caregiver Speech Therapist & PT/OT Physician Chaplain Dietician Social Worker
- 18. Teams with multiple disciplines S Transdisciplinary team: a team composed of members of a number of different professions cooperating across disciplines to improve patient care. http://medical-dictionary.thefreedictionary.com
- 19. Nurse Patient & Caregiver Speech Therapist & PT/OT Physician Chaplain Dietician Social Worker
- 20. Physician Patient & Caregiver Patient Caregiver
- 21. The Five Dysfunctions of a Team Inattention to Results Avoidance of Accountability Lack of Commitment Fear of Conflict Absence of Trust Lencioni, Patrick. The Five Dysfunctions of a Team. Jossey-Bass (April 11, 2002)
- 22. Healthy Teams S Value diverse professional perspectives S Promote a safe working environment S Equal power structure Wood, G, T Campbell. UNIPAC 5, Fourth Ed. Communication and Teamwork. Ed. C. Porter Storey, Jr., 2012, AAHPM.
- 23. Nurse Patient & Caregiver Speech Therapist & PT/OT Physician Chaplain Dietician Social Worker
- 24. Benefits of an IDT S Listens to patient story from diverse perspectives S Improve Patient Centered Care S Promote patient dignity, autonomy S Creative ways to promote beneficence Wood, G, T Campbell. UNIPAC 5, Fourth Ed. Communication and Teamwork. Ed. C. Porter Storey, Jr., 2012, AAHPM.
- 25. The combined perspectives of IDT members are much more likely to meet the complex needs patients and their families than any individual provider Wood, G, T Campbell. UNIPAC 5, Fourth Ed. Communication and Teamwork. Ed. C. Porter Storey, Jr., 2012, AAHPM.
- 26. Characteristics of Effective Teams Agree on a common set of principles, goals, and measurable objectives Wood, G, T Campbell. UNIPAC 5, Fourth Ed. Communication and Teamwork. Ed. C. Porter Storey, Jr., 2012, AAHPM.
- 27. Characteristics of Effective Teams Depend on and expect that competent individual members represent their discipline’s current practice standards Wood, G, T Campbell. UNIPAC 5, Fourth Ed. Communication and Teamwork. Ed. C. Porter Storey, Jr., 2012, AAHPM.
- 28. Characteristics of Effective Teams Share the responsibility for team functioning Wood, G, T Campbell. UNIPAC 5, Fourth Ed. Communication and Teamwork. Ed. C. Porter Storey, Jr., 2012, AAHPM.
- 29. Characteristics of Effective Teams Provide ongoing feedback in team interaction, leadership, communication, and conflict resolution Wood, G, T Campbell. UNIPAC 5, Fourth Ed. Communication and Teamwork. Ed. C. Porter Storey, Jr., 2012, AAHPM.
- 30. Team Interdependency S High level of interdependence consistently enhances team performance S Effective teams recognize, honor and use the expertise of each member of the team S Evaluate how each discipline can contribute to the goal S Recognize the need for role definition and role flexibility UNIPAC 5 p83 … resource 252 Wood, G, T Campbell. UNIPAC 5, Fourth Ed. Communication and Teamwork. Ed. C. Porter Storey, Jr., 2012, AAHPM.
- 32. Team decision making process Forsyth DR. Group Dynamics, found in UNIPAC 5
- 33. S How can this be applied to Clinical Ethics Consults?
- 34. Philosopher Ethics Consult Speech Therapist Physician Minister Nurse Social Worker
- 35. Paired Ethics Consult IDT Philosopher Nurse Physician Social worker Minister Speech Therapist Physician Minister Nurse
- 36. S Role Play: Organize yourselves into a three person IDT
- 37. Social Worker
- 38. Case #1 S Cases are Confidential
- 40. Social Worker
- 41. Case #2 S Cases are Confidential
Editor's Notes
- Diverse professional perspectives along with a safe working environment and equal power structure can lead to optimal patient-centered care. Using Palliative Care consultations as a model could improve quality and add diversity and professional depth to Clinical Ethics Consultations.
- Have institutional support Shared philosophy, goals, and norms Effective leaders and leadership styles with emphais on coordination Emphasis on team interdependency with role recognition and support Skilled communication and problem solving Shared decision making Flexibility and openness to new ideas Documentation of care that ensures accountability and confidentiality Effective collaboration with other healthcare providers, teams, and organizations Formal team self-evaluation to improve future performance Synergy, camaraderie, empowerment and fun
- Understand that a team’s success depends on each members’ ability to communicate effectively, work both independently and interdependently, and recognize individual and collective responsibilities Provide support and ongoing training to maximize the team’s effectiveness and the professional growth of each team member
- Understand that a team’s success depends on each members’ ability to communicate effectively, work both independently and interdependently, and recognize individual and collective responsibilities Provide support and ongoing training to maximize the team’s effectiveness and the professional growth of each team member
- Orientation: define the problem, set goals, plan the process Discussion; Gather information, identify alternative, evaluate alternatives Decision Making: choose the group solution Implementation: Adhere to the decision, evaluate the decision, seek feedback