Social workers’ perceptions of multi-disciplinary team work: A case study of health social workers at a major regional hospital in New Zealand
Keywords:multi-disciplinary teams, interdisciplinary communication, health social work, medical discourse
AbstractINTRODUCTION: International research has highlighted the importance of effective multidisciplinary team (MDT) functioning in health care settings: when collaboration between disciplines is effective, higher quality patient care results; whereas poor MDT functioning is associated with deleterious health outcomes. This study explores the findings of a small-scale case study into social workers’ views of MDT functioning at a major, regional public hospital in New Zealand.METHODS: Data was collected using in-depth interviews with eight health social workers and one focus group with three additional health social workers. Thematic analysis was used to identify key themes, and a discourse analysis undertaken to identify predominant discourses evident in the data.FINDINGS: Study participants considered that when MDTs were well-facilitated important non-medical aspects of patient care were addressed: patient care and discharge plans were communicated clearly and consistently to patients and families, and coordination between MDT members was effective. However, participants also identified occasions when the facilitation of MDTs was poor, where meetings were unstructured and unfocussed, and where social work and patient concerns with wider non-medical issues was devalued. Participants considered that such situations could lead to confusion and distress for patients and a failure to coordinate effective plans for discharge.CONCLUSION: The findings from this case-study suggest that, from the perspective of health social workers, ineffective facilitation of MDTs, an undue emphasis on the discourse of the patient as a ‘site of disease’, and a preoccupation with the management of risk can demote and devalue more holistic patient-centred perspectives, and the effectiveness of important, nonmedical aspects of patient care.
Atwal., A., & Caldwell, K. (2005). Do all health and social care professionals interact equally?: A study of interactions in multidisciplinary teams in the United Kingdom. Scandinavian Journal of Caring Sciences, 19, 268-273.
Atwal, A., & Caldwell, K. (2006) Nurse’s perceptions of multidisciplinary team work in acute care. International Journal of Nursing Practice, 2006; 12, 359-365. doi:10.1111/j.1440-172X.2006.00595.x
Bambra, C. Fox, D., & Scott-Samuel, A. (2005). Towards a politics of health. Health Promotion International. 20(2), 187-193. doi:10.1093/heapro/dah608.2005.2.18
Beddoe, E. (2014) Risk and vulnerability discourses in health. In L. Beddoe & J. Maidment (Eds.), Social work practice for promoting health and wellbeing: Critical issues (pp. 51-62). Oxon: Routledge.
Bronstein, L. (2003). A model for interdisciplinary collaboration. Social Work. 48(3), 297- 306.
Cheater, F. M., Hearnshaw, H., Baker, R., & Keane, M., (2005). Can a facilitated programme promote effective audit in secondary care teams: An exploratory trial. International Journal of Nursing, 42 (2005) 779-791. doi:http://dx.doi.org/10.1016/j.ijnurstu.2004.11.002
Connolly, M., & Harms, L. (2009). Social work: contexts and practice (2nd ed.). South Melbourne, Victoria: Oxford University Press Australia and New Zealand.
Fairclough, N. (1999). Linguistic and intertextual analysis within discourse analysis. In A. Jaworski & N. Coupland (Eds.), The discourse reader (pp. 183-211). London, UK: Routledge.
Giddens, A. (1999). Risk and responsibility. Modern Law Review, 62(1), 1-10. doi:10.1111/1468-2230.00188
Good, B.J. (1994). Medicine, rationality and experience: An anthropological perspective. Cambridge University Press: New York.
Haultain, L. (2013). Facing the challenges together: Future vision for health social work. In E. Beddoe & J. Maidment (Eds.), Social work practice for promoting health and wellbeing: Critical issues (pp. 39-50). Oxford, UK: Routledge.
Liepzig, R.M., Hyer, K., Wallenstein, S., Vezina, M., Fairchild,
S., Cassel, C.K., & Howe, J.L. (2002). Attitudes toward working on interdisciplinary healthcare teams: A comparison by discipline. Journal of the American Geriatrics Society, 50(6), 1141-1148.
Opie, A. (1997). Thinking teams thinking clients: Issues of discourse and representation in the work of health care teams. Sociology of Health & Illness. 19(3), 259-280. doi:10.1111/j.1467-9566.
Pollack, S. (2010). Labelling clients `risky’: Social work and the neo-liberal welfare state. British Journal of Social Work, 40(4), 1263-1278. doi:10.1093/bjsw/bcn079
Tolich, M., & Davidson, C. (2011). Getting started: An introduction to research methods. Auckland, New Zealand: Pearson New Zealand.
World Health Organisation (2011). World conference on social determinants of health: Closing the gap: Policy into practice on social determinants of health. Discussion paper. Rio de Janeiro, Brazil: Author. Retrieved from http://www.who.int/sdhconference/Discussion-paper-EN.pdf
Zwarenstein, M., Goldman, J., & Reeves, S. (2009). Interprofessional collaboration: Effects of practice-based interventions on professional practice and healthcare. Cochrane Database of Systematic Reviews, 3, 1-30. doi:10.1002/14651858.CD000072.pub2
How to Cite
Authors who publish with this journal agree to the following terms:
By completing the online submission process, you confirm you accept this agreement. The following is the entire agreement between you and the Aotearoa New Zealand Association of Social Workers (ANZASW) and it may be modified only in writing.
You and any co-authors
If you are completing this agreement on behalf of co-authors, you confirm that you are acting on their behalf with their knowledge.
By submitting the work you are:
- granting the ANZASW the right of first publication of this work;
- confirming that the work is original; and
- confirming that the work has not been published in any other form.
Once published, you are free to use the final, accepted version in any way, as outlined below under Copyright.
You assign copyright in the final, accepted version of your article to the ANZASW. You and any co-authors of the article retain the right to be identified as authors of the work.
The ANZASW will publish the final, accepted manuscript under a Creative Commons Attribution licence (CC BY 4.0). This licence allows anyone – including you – to share, copy, distribute, transmit, adapt and make commercial use of the work without needing additional permission, provided appropriate attribution is made to the original author or source.
A human-readable summary of the licence is available from http://creativecommons.org/licenses/by/4.0, which includes a link to the full licence text.
Under this licence you can use the final, published version of the article freely – such as depositing a copy in your institutional research repository, uploading a copy to your profile on an academic networking site or including it in a different publication, such as a collection of articles on a topic or in conference proceedings – provided that original publication in Aotearoa New Zealand Social Work is acknowledged.
This agreement has no effect on any pre-publication versions or elements, which remain entirely yours, and to which we claim no right.
Reviewers hold copyright in their own comments and should not be further copied in any way without their permission.
The copyright of others
If your article includes the copyright material of others (e.g. graphs, diagrams etc.), you confirm that your use either:
- falls within the limits of fair dealing for the purposes of criticism and review or fair use; OR
- that you have gained permission from the rights holder for publication in an open access journal.