Achieving teamwork in stroke units: The contribution of opportunistic dialogue

Abstract

Collaborative interdisciplinary working is central to contemporary health policy. The specialized and co-ordinated multidisciplinary care provided in stroke units is considered to contribute to improved patient outcomes in such units. However, how stroke unit teams co-ordinate their work is not clearly understood. This paper reports on a grounded theory study which explains how health professionals in two stroke units in northern England achieved teamwork. Data were generated through 220 hours of participant observation and 34 semi-structured interviews. Interviews were undertaken during and following participant observations. A basic social process common to teamworking in both units was identified; this was termed "opportunistic dialogue". The division of labour in respect of rehabilitation activities was negotiated through this interactional process. Co-location of most team members led to repeated engagement in sharing patient information and in exploring different perspectives. Opportunistic dialoguing contributed to mutual learning and explained the shift in thinking and team culture as team members moved from concern with discrete disciplinary actions to dialogue and negotiations focused on meeting patients' needs. The findings indicate that routinely incorporating periods of joint working in which team members articulate the reasoning for their decisions and interventions, contributes to achieving interdisciplinary teamworking in rehabilitation settings.

Nurses’ perceptions of their role in rehabilitation of the older person

“…Furthermore, older adults do not associate nurses with a rehabilitative role, but rather expect nurses to assist and support them in their daily care (Long et al 2002). While various descriptions of the role of nurses in rehabilitation of the older person can be found in the literature and acknowledging that nurses play an integral part in the rehabilitation process (RCN 2007, Barreca and Wilkins 2008, Clarke 2010, no study has been undertaken to explore nurses' perceptions of their role in rehabilitation of the older person in the Irish context.…”

The Evidence of Interdisciplinary Teamwork in the Rehabilitation of Stroke Patients with Aphasia

“…Those with aphasia received less information and communication time compared to stroke patients without aphasia [14]. Social and emotional well-being was incorporated in the goalsetting by including information and involving families [11]. The goal for patients with LIS is threefold; to establish and maintain optimal respiration, nutrition and communication [21].…”

“…Core team members shared knowledge, experiences and values in negotiations about decisions pertaining to agreed goals [11].…”

“…The PSC tool provides a common platform for performing quality of life interventions [20]. In order to constantly tailor the interventions they were negotiated both in structural meetings and on the spot [11].…”

“…Assessment of activity, participation and environment is important [11] [14] [19]. A user-friendly Aldous et al…”