Structure and Meaning in Multidisciplinary Teamwork

Abstract

The purpose of this study was to examine the relationship between structure and meaning in multidisciplinary long-term care teams. In-depth semi-structured interviews were conducted with 26 staff working on five multidisciplinary teams in the same long-term care facility in Metropolitan Toronto. Staff in different structural locations have differing meanings of work and teamwork. Direct caregiving nursing staff have simple role-sets, minimal involvement in team decision-making and ritualistic orientations towards their work and teamwork. Multidisciplinary professionals have complex role-sets, greater involvement in team decision-making and organic orientations towards their work and teamwork. Supervisory nurses are in a contradictory structural location and shared aspects of both orientations to teamwork. The lack of shared meanings results in alienation from work and teamwork for staff in lower structural positions which, in turn, has considerable implications for team functioning.

Multidisciplinary Teamwork in a UK Regional Secure Mental Health Unit a Matter for Negotiation?

“…Such findings do not rule out the possibility that communication can bridge differences between the interpretive frameworks associated with professional disciplines. However, the research discussed in this paper supports the view that versions of interactionism which emphasise interpretation and rolemaking underestimate the impact of power inequalities upon the capacity of professional groups to communicate across occupational boundaries (Morgan et al, 1985;Cott, 1998).…”

“…Similar conclusions have been drawn in other healthcare arenas. Far from promoting collaboration, multidisciplinary interaction appears, paradoxically, to reinvoke professional boundaries (Cott, 1998;Brown et al, 2000;Coffey and Jenkins, 2002;Hugman, 2003).…”

“…However, the partnership vision is driven more by conviction than by compelling evidence that collaboration can generate service improvements (Barr, 2000). Similarly, the literature on the value of professional collaboration in health care tends to be prescriptive and journalistic rather than analytic and evidentially based (Cott, 1998;Glasby and Lester, 2004). The idea of multidisciplinary teamwork raises a number of conceptual problems.…”

“…As Cott (1998) has observed, little theoretical or empirical work has attempted to 'get inside' multidisciplinary healthcare work. This issue will be explored below from a symbolic interactionist framework which provides a particularly useful basis for analysing organisational life underpinned by the intersections of multiple systems of meanings.…”

Shared Care and Interprofessional Practice

“…A range of views are essential to a multidisciplinary approach but where destructive differences are not addressed those in inferior hierarchical positions tend to feel alienated with the potential loss of their knowledge and input to the team (Cott, 1998). The Confidential Inquiry into Homicides and Suicides found that inter-professional disagreements were often detrimental to the care of the user with the potential for tragic consequences (Royal College of Psychiatrists, 1996).…”