Garret Lundquist Quisao Qualres

Garret, Lundquist, Quisao
OT roles within interdisciplinary teams
Occupational Therapys Perceived Roles Within Interdisciplinary Teams

Interdisciplinary teams within the healthcare setting have been proven to facilitate higher
levels of interaction and communication and have been associated with lower patient mortality
rates (Vinokur-Kaplan, 1995). Occupational therapy (OT) continues to hold a significant role
within the healthcare setting. However, the contributions of OTs may be perceived as vague and
unclear to interdisciplinary health care professionals. Most participants expressed their lack of
confidence with recommending OT services for clients, because they were not sure of what OT
could offer, or what they should be referring clients for (Smith & Mackenzie, 2011 p. 257). This
lack of role understanding has been consistent throughout the previous research (Smith &
Mackenzie, 2011). The issue reportedly stems from difficulty of OTs ability to clearly articulate
their role, which in turn impacts the amount of understanding from professionals in other
disciplines. (Smith & Mackenzie, 2011).
We would like to understand other healthcare professionals perceptions of OTs and the
basis for their views and opinions. Our interest in this particular topic developed as a result of
personal interdisciplinary experience within the medical and health sciences school setting.
Minimal research has addressed the perception of OT from outside the profession
The purpose of this qualitative study is to explore the perception of interdisciplinary
teams that include OTs. Our working definition of interdisciplinary teams is a collection of
healthcare professionals from diverse fields who work in a cooperative manner by actively
communicating in order to meet common goals for the client. We will study interdisciplinary
teams that include OTs from the perspectives of healthcare professionals within the team. The
overarching research question is how do members of a healthcare interdisciplinary team perceive
an OTs contribution and role within the team?
Literature Review
Multidisciplinary Team versus Interdisciplinary Team
According to Simpson, Bowers, Alexander, Ridley, and Warren (2005), OTs play an
important role in a multidisciplinary team, but their involvement could increase with additional
interprofessional education. Simpson et al., (2005) explored OT and interprofessional
interactions with other members of the team, particularly in the acute psychiatric setting. The
authors described multidisciplinary teams as collaboration between agencies and professional
disciplines in order to improve the quality of service provision (Simpson et al., 2005). However,
multidisciplinary teams have minimal communication, and as a result, a collaborative, holistic
approach is difficult to achieve (Korner, 2009). A major difference between this study and our
current research is that we are aiming to explore interdisciplinary teams, not multidisciplinary
teams. An interdisciplinary team has been defined as professionals who meet on a regular basis
to discuss and collaborate to set treatment goals for the patients and jointly carry out the
treatment plans (Korner, 2009). There is a high degree of communication and collaboration of
team members. (Korner, 2009).
Simpson et al. (2005) emphasized the importance of the need for OTs to clarify their roles
within the multidisciplinary team with other health professionals. The findings of Simpson et al.
(2005) were presented under themes including; barriers to involvement with patients,
multidisciplinary working, participation, and interprofessional training. Smith and Mackenzie
(2011) found that positive interdisciplinary relationships are necessary for continuity of care with
patients, particularly within the mental health setting. Nurses and OTs commonly work
separately with clients who have separate goals and plans. Collaboration is fundamental to the
interdisciplinary process, but it was found that it was not an integral part of daily work (Smith &
Mackenzie, 2011). OTs reported that their skills and expertise were not used in treatment
planning to their highest potential. Discharge of patients often occurred before they were truly
prepared to cope in the community. Several OTs reported that they would like to have a larger
role in assessing preparedness prior to discharge (Simpson et al., 2005). Another occupational
therapist spoke of feeling out of the loop regarding much of patient information (Simpson et al.,
2005). Smith & Mackenzie (2011) found that nursing participants in their research expressed
strong concerns that their nursing territory was being encroached upon by OT. On occasion, team
meetings were scheduled at times that were inconvenient only for the OTs. This issue was often
described to be a lack of respect for OTs by other team members. Another member of the nursing
staff described OTs as a positive resource, but their opinions were not usually considered
regarding important decisions. This nurse continued to mention that OTs are unfortunately not
typically treated as equal professionals due to their lower profile within the psychiatric ward
(Simpson et al., 2005). OTs were not considered professional equals to nurses because they held
a lower profile within the psych ward and interprofessional training is an important aspect of
multidisciplinary team interaction (Simpson et al., 2005).
An important aspect of multidisciplinary team interaction mentioned within Smith &
Mackenzie (2011) study described the need for interprofessional training. Many of the other
professionals within the multidisciplinary team each attended their own disciplines training
courses and some courses overlapping into other disciplines as well as leadership and
management courses. However, the OTs were not usually a part of this (Simpson et al., 2005).
Each profession appeared to know very little regarding other disciplines training, specifically
OTs. It is vital that educators have a role in preparing individuals to work in an interdisciplinary
setting with other health professionals, but developing interprofessional learning opportunities
(Smith & Mackenzie, 2011). An OT discussed with a supervisor the lack of interaction between
the disciplines and nursing courses are being made available for OTs to improve and model
collaboration and multidisciplinary interaction.
Based on the current research, we conclude that more integrated teams with increased
interprofessional collaboration would produce better patient outcomes. Another important aspect
to note is that more education and description about OT would aid team members from other
disciplines to appreciate and utilize OTs more consistently. Occupational therapists should take
the initiative by seeking opportunities to develop effective communication and collaboration with
other health professionals in the interdisciplinary team to define and promote their discipline
(Smith & Mackenzie, 2011).
The authors (Smith & Mackenzie, 2011) did not fully explore the perspectives of team
members from disciplines other than OT. Only OTs were surveyed to elicit their perception of
their role in the psychiatric ward. Therefore, the authors findings are limited to a small setting
and do not have high external validity. Also, this study was conducted in just one demographic
location with limited participants. The addition of more facilities in other locations, which
include multidisciplinary teams, would be effective in increasing transferability to a larger
population. Additionally, this study focused on multidisciplinary teams instead of
interdisciplinary teams. Thus, the interaction between the teams does not precisely align with our
phenomenon.
Interdisciplinary Team Effectiveness in Various Settings
Neumann et al. (2009) are delegates and members of the Professional Practice
Committee. The authors examined the rationale of interdisciplinary teams working in Physical
and Rehabilitation Medicine (PRM) and described the best working patterns for these groups of
people. The authors explained that PRM strives to optimize activity, social participation, and
quality of life of people with conditions ranging from acute to chronic (Neumann, Gutenbrunner,
Fialka-Moser, Christodoulou, Varela, Giustini, and Delarque, 2009, p. 5). Fossey (2001)
described what makes an interdisciplinary team effective from an OT perspective. The main
concepts from this research included the focus and scope of OT, occupational therapists
responsibilities within an interdisciplinary team, and the keys to effective teamwork.
Interdisciplinary teamwork has been described as being essential to diagnose, assess
impairments, activity limitations and participation restrictions, and treatment options (Neumann
et al., 2009). Neumann et al. (2009) described that no clinician has all of the skills needed to
meet all the needs of each patient, and if team members respect and have mutual goals, optimal
goals can be reached. A few features listed to promote organization within an interdisciplinary
team include agreed aims, mutual trust and respect, and willingness to share knowledge and
expertise and speak openly. Although all members of the team should have these qualities, their
specific profession carries its own responsibilities (Neumann et al., 2009, ).
Upon examination of the focus and scope of OT, Fossey (2001) described OT as being
concerned with the occupational dimension of peoples lives. Occupations are critical to
peoples physical, social and mental well beings. OT is critical in the mental health field, and
people with mental illnesses often do not have occupations, which is where OT can come in to
help people to live more fulfilling lives (Fossey, 2001).
Fossey (2001) goes further to explain the role of OT in an interdisciplinary team,
describing the various members that make up a team involved in the mental health field.
Members include psychologists, social workers, case workers, psychiatrists, nurses and
occupational therapists. OT can help people struggling with mental illnesses receive various
skills that are crucial to living a productive life (Fossey, 2001). Interdisciplinary teams need to
respect other healthcare disciplines views on what is needed for the client. Open
communication is crucial in order to achieve optimal success in reaching clients ultimate goals.
Throughout the research, Neumann at al. (2009) clearly stated that the requirement for an
interdisciplinary team is to be productive. The article does not, however, look at either the
perception of professionals about other professionals within the team or their beliefs about each
members contributions. Fossey (2001) did a good job of examining members of an

interdisciplinary mental health team and defined to the requirements of an effective team. A
major barrier addressed in this article is the awareness and understanding of each team members
role within the team. Often times, members' roles overlap providing an opportunity for
collaboration (Fossey, 2001, p.234). Fossey, 2001 explains that to provide valuable and effective
treatment, each member needs to understand and utilize each others strengths (p. 234).
Additionally, the perspective of other healthcare disciplines think of OT is not addressed. Thus, it
is necessary to examine how other disciplines view OT.
After reviewing current literature related to our topic, it is apparent that the majority of
individuals involved in healthcare support the importance of interdisciplinary teams but have
little understanding about those working on the team with them. It is important as a member of
an interdisciplinary team to understand the role and strengths of each profession to ensure those
receiving services experience the best treatment possible.
This study focuses on how individual members of the team view the benefits of working
on an interdisciplinary team, as well as how they view the contributions of a particular profession
occupational therapy.
With continued research in this area to help providers comprehend the importance of
understanding all aspects of professional on the interdisciplinary team, the patients can expect to
receive a more holistic and collaborative approach throughout treatment. A more holistic and
collaborative approach to treatment will ultimately safeguard a high quality of treatment.
Current Research
The current research will describe how occupational therapists are perceived within an
interdisciplinary team and allow for improvement in interactions across disciplines. The
information gathered will discuss how OTs are viewed by others in order to help increase OTs
effectiveness within the team, to encourage early interdisciplinary education, as well as
demonstrate the importance of OT within the team to expand coverage. Most importantly, this
study will aide in improving collaborative, integrated interactions with occupational therapists
and other team professionals to present higher outcomes for clients.
Methodology
Research Design
The question we are looking into is, how do members of a healthcare interdisciplinary
team perceive an OTs contribution and role within the team? By using a qualitative research
design, we could gather the individual members stories and experiences of working with OTs as
part of the interdisciplinary team.
The research approach for this study was a phenomenology. A phenomenology allowed
us to study interdisciplinary teams as a whole, explore how they interacted, and determine what
their perceptions were of OT. We interviewed various members of an interdisciplinary team and
putting together their stories about interdisciplinary teams and perceptions on the field of OT.
After we have conducted the interviews we will be synthesizing the data and presenting the
various members of the interdisciplinary teams views in a qualitative research paper.
Participants
In our interviews we were able to interview a total of 3 individuals. The participants
were mainly conducted with professors here at Touro University Nevada. The sample of our
participants were 2 females and 1 male. In order to recruit members for our study, we sent
out an email to the faculty at Touro if any professors who had been part of an interdisciplinary
team would be interested in participating in our study. At the end of every interview we
conducted we asked if they knew anyone else who would be interested in participating in our
study. We had a plan to recruit as many people as we could for our study; our requirements
were that they had to have been part of an interdisciplinary team. They also needed to be part
of the medical community, and we tried to get a variety of professionals.
Data Collection
For this study, the majority of data was collected through interviews both in person and
over the phone, with the exception of one e-mailed document to accommodate for a distance
barrier. Interviews were the primary method to collect data, allowing each participant to portray
and express their opinions and perspectives in a clear way. Additionally, interviews permitted the
interviewer to ask questions and clarify information being provided. Our interview was set up
with an open-ended design to allow the interviewer to provide information the interviewer may
not have considered. One participant was unable to meet due to distance barrier therefor an emailed document was used to collect data in a more structured manner from this participant.
The participants were informed prior to the collection of data that the information provided
would be included in a class qualitative research project. The researchers clarified that all
information provided would be remain anonymous, and identifying information would be
included in the study.
The interviews took place over the course of two weeks, each lasting between 8-15
minutes. The questions utilized set direction for the conversation and kept the participant on the
correct topic. However, each participant was allowed to provide additional information due to the
open-ended format. An example question used in each of the interviews was, What are the
benefits of working in an interdisciplinary team?
A complete list of questions used in the interviews in included in Appendix A.
.
Data Analysis
Upon completion of data collection, each in person and over the phone interview was
transcribed verbatim by 3 researchers in order to achieve triangulation. The email
correspondence interview was completed and submitted by the interviewee, thus further
transcription was unnecessary. Narrative analysis was conducted in order to gather various health
professionals perspectives based on interviews. The rationale for using narrative analysis stems
from its attempt to understand particular events in a meaningful progression. Narrative analysis
allowed the researchers to preserve the integrity of personal narratives and codes each story as
a whole and not segmentally.
The process of coding was conducted sequentially according to each question. Each
question was categorized and coded in a spreadsheet format individually and given a general
code term. A corresponding description of each participants response to the questions was
entered into the spreadsheet. The researchers then analyzed response and identified patterns in
each analogous question and code. An example from the coding process for the question, What
are the benefits of working in an interdisciplinary team? are as follows: Q1 (Practice Setting)
is the code name and Outpatient pediatric clinic is the text applied to that particular code.
A verbatim transcript of ten minutes of an interview is included in Appendix____.
Findings
One of the themes from our study was that physical therapy and speech were the two
professions that collaborated with occupational therapists on interdisciplinary teams the most. A
common theme concerning the benefits of an interdisciplinary team was that collaboration
among team members and team work were the best ways to help a client. When asked about
what the strengths of occupational therapists were, the answers differed among those
interviewed. The responses ranged from being a good resource for team members, to providing
consistent interactions with the clients.
As a group, the researchers collaborated to transcribe the interviews. After each
interviews, we coded the data and put it together in a spread sheet. Our group was able to come
to a consistent conclusion on what the data meant, and no disagreements existed among us.
Our original research question is how do members of a healthcare interdisciplinary team perceive
an OTs contribution and role within the team? Our findings suggest that among the people we
interviewed they all had positive things to say about occupational therapy. Not one of the people
we interviewed had anything negative to say about their experience working with occupational
therapists. Our findings were consistent with the previous research done on interdisciplinary
teams. In the study by Simpson on multidisciplinary vs. interdisciplinary teams, the author
emphasizes the importance of members of the multidisciplinary team understanding each others
roles. This was a common theme that we discovered when reviewing the research. All of the
people we interviewed expressed the importance of understanding the roles of the different
health care providers. In the study on interdisciplinary teams effectiveness in various settings, the
author explains that no practitioner has all the knowledge necessary to help the client achieve
optimal results therefore teamwork is necessary in the recovery of the client. The people we
10
interviewed expressed similar opinions and believed that more could be achieved through
teamwork than could be achieved by themselves. Overall our findings were consistent with the
research that has already been produced on interdisciplinary teams.
Conclusions
The primary purpose of this study was to explore the perceptions of various healthcare
professionals on interdisciplinary teams that include OTs. The previous research suggested that
some practitioners were unsure of referring clients to OTs because they were unaware of what
occupational therapy could do for the client. What we discovered when interviewing various
healthcare professionals was that, those who had worked with occupational therapists all had
positive experiences in interdisciplinary teams. We chose participants who worked on an
interdisciplinary team with OTs. We interviewed the healthcare professionals to get their
perspective of working with OTs. This approach allowed the researchers to answer the
overarching research question regarding how members of a healthcare interdisciplinary team
perceive an OTs contribution and role within the team. Each participant of this research had
positive experiences with OT, and did not have negative responses regarding their experience
with occupational therapy.
The current research has several limitations including: Describe any limitations of your
study. What was beyond the scope of your study? What future research is needed?
Articulated repeatedly throughout the majority of the interviews was the importance of
utilizing the specific skills and knowledge of each healthcare professional within the team to
provide effective treatment to each client. As one participant stated, I think its just really
taking the time to really broaden your horizons and expertise. You know, I didnt go to school to
become an OT, so if I listen and take that input its going to make me a better therapist and there
will be better outcomes in the end.
11
Appendix
Appendix A
List of questions.
1. What type of setting do/did you work in as a part of an interdisciplinary team?
2. What other healthcare professionals were members of your interdisciplinary team?
a. What was the distribution of members?
3. What are the benefits of working in an interdisciplinary team?
4. How would you describe occupational therapy?
5. How did the occupational therapist(s) contribute to the interdisciplinary team? What were
OTs roles within the team?
a. Strengths?
b. Weaknesses?
6. If you had a magic wand and you could change anything, what would be your wish?
7. Is there anything else that you think I should know in order to help me to better
understand interdisciplinary teams and team members roles?
8. Do you know of any other healthcare professionals who have worked in an
interdisciplinary team who may be interested in participating in our study?
Appendix B
Interview transcriptions.
In person transcription.
A: Alyssa Speaking.
S: Hi Alyssa, this is Josee and Nicole, the students from Touro University calling to interview
you.
A: Oh, Hi How are you?
12
S: Good How are you?

A: Good Thank you
S: Just to fill you in on what we are doing our interview about, For our research class, we are
interviewing people that have worked in interdisciplinary teams with OT to get their
perspective on how the OT contributes to the team.
A: okay
S: So we just have a few questions for you. Are you ready?
A: Yes
S: Okay great. First we just wanted to get an idea of what type of setting do you work in
when you are working on an interdisciplinary team.
A: Currently I own my own company, and I have a contract with Care Meridian and we
provide PT, OT, and Speech at the facility, and I am also a speech therapist that provides
therapy at the facility.
S: Okay, and can you repeat the name, did you say Care Meridian?
A: Yes, Care Meridian. Its where we have the contract.
S: Oh, okay.
S: So what other healthcare professionals are members of your interdisciplinary team?
A: PT OT Speech and respiratory therapy
S: Okay, and what would you say the distribution the members are in terms of 1 OT verses 2
PTs, or anything like that.
A: We actually have two of everything. 2 PT, 2 OT, 2 Speech, and then office per diem.
S: okay thank you.
A: What would you say the benefits of working in an interdisciplinary team are in general, in
your opinion?
S: Well I just think that youre trying to meet the needs of the child in functional ways that
are from difference perspectives, and different training and you can just really put those
pieces together and meet functional outcomes better.
A: Okay, just one second.
S: How would you describe, if someone was to ask you what OT is, how would you describe
it to someone?
A: What they do?
S: Yes
A: Well it really depends on who you are talking to. When I try to put it in laymans terms, I
think it depends on if I am talking to an adult who is here in rehab then I really explain the
13
functional end and ADLS, the fine motor, and the upper body type thing. And I try to really
relate it to their daily life so they can see the benefits.
If we are talking about a child, you know with special needs, the sensory piece come in to
play so it really depends on the audience how I present it.
S: Okay. But you like to focus on trying to relate it to their daily life no matter what?
A: Yes for the adult definitely. You know, and depending on the persons background, and
education level, you know sometimes they might have a hard time grasping certain concepts
so I try to really relate it to something functional and in their daily life.
S: Okay. And in your experience working in an interdisciplinary team, how did the OTs
contribute and participate in the working experience?
A: Well we do co-treats, and we really just bring our different areas and expertise, and
definitely when Im working with different sensory issues, its a big help to work on that
sensory integration piece. . Um, I am very big on the augmentative and alternative
communication, so working with positions and access, things like that, so OT has been very
valuable.
S: Okay, would you say that there are any weaknesses in terms of your experience with OTs
contribution to the team?
A: Not really with me. I think that everybody is at a point in their career as a professional,
and I have not really had any issues. You know, I think its how you communicate with one
another, and learn to be respectful of different educational experiences. But I havent had any
issues in my career.
S: Okay, Is there anything else that you would like to share with us regarding
interdisciplinary teams and the team members roles that you would like us to know, or think
might be helpful for us to understand the dynamic?
A: I dont think so; I think its just really taking the time to really broaden your horizons and
expertise. You know, I didnt go to school to become an OT, so if I listen and take that input
its going to make me a better therapist and there will be better outcomes in the end. Thats
really it.
14
S: Okay. I believe that is about all of our questions. I just want to check with out, and make
sure you are okay using this interview within our research class.
A: Yes that is fine.
S: Okay, well thank you for your time, and answering all of our questions.
A: Yeah, youre welcome. Good Luck with your project.
S: Thank you, have a good day.
A: Take Care, Bye
Email transcription.
1. What type of setting do/did you work in as a part of an interdisciplinary team?
a. I currently work at St. Lukes Rehabilitation in Spokane, Washington, where I am
a member of the Spinal Cord Units Interdisciplinary team.
2. What other healthcare professionals were members of your interdisciplinary team?
a. Other members of the team include: Occupational Therapy, Physical Therapy,
Speech Therapy (eating), Nursing, Physician Assistants, Physicians, OTA, PTA,
Psychiatrist, Respiratory therapy, and social workers.
3. What was the distribution of members?
a. There are three different teams within the Spinal Cord Unit, and each team has 2
PT, 2 PT, 1 COTA, 1PTA, and 1 Social Worker.
b. There is 1 respiratory therapist, 1 speech therapist, and 1 Psychiatrist, and 1
Recreational Therapist shared between the 3 teams on the unit.
c. There are usually about 6 nurses on the unit, and there are 5 physicians and 5 PA
that have patients on the unit.
4. What are the benefits of working in an interdisciplinary team?
a. There are a lot of benefits of working on an interdisciplinary team. Personally, I
rely on the other therapists on the unit to recognize when a patient would benefit
from my services because RT is not a service automatically requested by the
physician yet a lot of the patients are beginning a new chapter in their life in a
wheel chair and need help to get back to the recreational activities they enjoy. I
also think that working on a team ensures the patient will receive the best
treatment possible because where one person lacks, there is usually someone else
15
on the team that excels in this area. The weakness there needs to be good
communication and good documentation to make sure that each team member is
in the loop and everyone is on the same page for each and every client.
5. How would you describe occupational therapy?
a. Occupational therapy helps patients learn or re-learn the tasks they need to
complete each day to live. In inpatient rehab, the OTs focus on ADLS, IADLS,
and a lot of safety planning for post discharge. I usually will explain to a patient
that they are the people that are going to get you as independent as possible to
dress yourself, go to the bathroom, eat, and other things you need to do.
6. How did the occupational therapist(s) contribute to the interdisciplinary team? What were
OTs roles within the team?
a. The occupational therapists were a big contribution to the team, because they are able
to help patients complete tasks that used to be automatic to them successfully which
is a big impact on someone who is in rehabilitation with a spinal cord injury. They are
also very aware safety, which is a big help to the team because not everyone always
thinks about all of the safety factors like the OTs do.
7. Is there anything else that you think I should know in order to help me to better
understand interdisciplinary teams and team members roles?

a. Just remember that everyone has their strengths, and its important to utilize
everyones strengths so dont be afraid to collaborate with other members.
Appendix C
Spreadsheet.
References
Fossey, E. (2001). Effective interdisciplinary teamwork: an occupational therapy perspective.
Australasian Psychiatry, 9(3), 232-235. doi:10.1046/j.1440-1665.2001.00334.x
16
Korner, M. (2009). Interprofessional teamwork in medical rehabilitation: a comparison of

multidisciplinary and interdisciplinary team approach. Clinical Rehabilitation, 24, 746-755. doi:
10.1177/0269215510367538
Simpson, A., Bowers, L., Alexander, J., Ridley, C., Warren, J. (2005). Occupational therapy and
multidisciplinary working on acute psychiatric wards: The Tompkins acute ward study. British
Journal of Occupational Therapy, 68(12), 545-554.
Smith, E., Mackenzie, L. (2011). How occupational therapists are perceived within inpatient mental
health settings: The perceptions of seven Australian nurses. Australian Occupational Therapy
Journal, 58, 251-260. doi: 10.1111/j.440-1630.2011.009944.x
Stake, R. E. (2010). Qualitative research: Studying how things work. New York, NY: Guilford Press.
Neumann,V., Gutenbrunner, C., Fialka-Moser, V., Christodoulou, N., Varela, E., Giustini, A., &
Delarque, A. (2009). Interdisciplinary Team Working in Physical and Rehabilitation Medicine.
The Journal of Rehabilitation Medicine, 42, 4-8.
Vinokur-Kaplan, D. (1995). Treatment teams that work (and those that dont): An application of
hackmans group effectiveness model to interdisciplinary teams in psychiatric hospitals. Journal
of Applied Behavioral Science, 31, 303-327.

Garret Lundquist Quisao Qualres

Hochgeladen von

Dokumentinformationen

Originalbeschreibung:

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Garret Lundquist Quisao Qualres

Hochgeladen von

Copyright:

Verfügbare Formate

Garret, Lundquist, Quisao

OT roles within interdisciplinary teams

Occupational Therapys Perceived Roles Within Interdisciplinary Teams