Collegiality in interdisciplinary health teams: Its measurement and its effects

Medical dominance in multidisciplinary teamwork: a case study of discharge decision-making in a geriatric assessment unit Aim To investigate the degree of medical dominance in multidisciplinary teams in a geriatric assessment unit by focusing on decision-making with regard to patient discharge. Background The persistence of medical dominance in multidisciplinary teamwork has been widely assumed but insuf®ciently researched, particularly through close observation of team practice. The present study seeks to rectify this by examining the extent of medical dominance in two multidisciplinary teams working in a hospital-based geriatric assessment unit. Methods Team practice was analysed by observing and audiotaping ®ve case review meetings in each team and by semi-structured interviews with team members. Results In terms of level of contribution, the issues raised at meetings, and the team responses to discharge initiation, a lower than expected level of medical dominance was identi®ed. This lower than expected level is related to consultants' views on the nature of rehabilitation, leading to a consensus amongst team members as to the purpose of geriatric assessment, and to a high level of team stability. Conclusion Reducing the level of medical dominance encourages the contributions of all team members and thus enhances patient care. More training in team skills would also be bene®cial, including interprofessional training.

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“…Bultema et al . 1996, Feiger & Schmitt 1979; Hendriksen et al . 1984, McGrath 1991, Ovretveit 1990, Toseland et al .…”

Section: Introductionmentioning

confidence: 99%

Medical dominance in multidisciplinary teamwork: a case study of discharge decision-making in a geriatric assessment unit

Gair

Hartery

2008

Journal of Nursing Management

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Navigating the Hierarchy: Communicating Power Relationships in Collaborative Health Care Groups

Noyes

2021

Management Communication Quarterly

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Interdisciplinary health care groups increasingly face issues related to power and authority in the patient care process. Many of these issues stem from a tension between the historically entrenched hierarchy in health care organizations and the growing pressure of collaborative models of care that require a flattening of this hierarchy, greater mutual respect among disciplines, and more willingness to share power. This project used the framework of text and conversation to explore how groups negotiate this tension through communication. Findings suggest how some groups navigate texts that reinforce the hierarchy alongside texts that challenge it, creating a delicate balance of power that supports collaboration without threatening the position of those at the top of the hierarchy. Other groups primarily use texts that reinforce the hierarchy without consistently using texts that challenge it, which seems to make collaboration more difficult. These findings challenge the idea that equal balance should always be the goal of power sharing in collaborative interdisciplinary groups and offer a more nuanced understanding of how everyday group communication creates and recreates power relationships that impact collaborative care.

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Collaboration: A Tool Addressing Ethical Issues for Elderly Patients Near the End of Life in Intensive Care Units

Baggs¹,

Mick²

2000

J Gerontol Nurs

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Collegiality in interdisciplinary health teams: Its measurement and its effects

Cited by 3 publications

References 14 publications

Medical dominance in multidisciplinary teamwork: a case study of discharge decision-making in a geriatric assessment unit

Medical dominance in multidisciplinary teamwork: a case study of discharge decision-making in a geriatric assessment unit

Navigating the Hierarchy: Communicating Power Relationships in Collaborative Health Care Groups

Collaboration: A Tool Addressing Ethical Issues for Elderly Patients Near the End of Life in Intensive Care Units

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