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Rehabilitation team members

The posts in this category consider or discuss the expertise the team member’s profession adds to the team. The term includes all members, extending to the patient, rehabilitation assistant and other people without a particular professional qualification, family members, and staff who work on the ward or where the patient attends. Every interaction counts, and every person contributes. One way to consider the matter is to ask, “What professional (or other) knowledge or skill do I have as a (whatever you are) that other team members will not have?” For example, a family member will know the person before the illness starts, a doctor will know the benefits and risks of drugs, and a person serving tea will see how the patient interacts in a more normal situation. Someone with the given status writes the content of each post; I will provide advice and check it, improving it if necessary but always in conjunction with the author. Unless they request not, the author(s) will be named and acknowledged. If you are interested in contributing, please get in touch with me. I welcome several views on the value of each team member because each will have a different perspective.

Table of Contents

Introduction.

Multi-professional teams provide the best outcome for any complex problem, which is true in rehabilitation. There is considerable debate about the optimum size of a team and, in rehabilitation, about the group’s membership and whether it should be multidisciplinary, interdisciplinary, or transdisciplinary.

Discussions on membership raise two issues. The simpler one is, what professions constitute a rehabilitation team, or at least the core team? Any healthcare professional might have a vital role in the patient’s rehabilitation. Consequently, the required team members will be statistically determined based on the caseload’s nature. I would suggest that the rehabilitation team should be able to assess, advise on, and treat 80% of the clinical problems seen from within their group. In 20% of situations, someone outside the team may be needed.

The more challenging problem is, who constitutes the patient’s team? First, a rehabilitation team often has several people from the same profession; only one will be involved with the patient. Second, people outside the rehabilitation team, such as social workers, community nurses, or general practitioners, will be involved. Third, the patient will also be in contact with many influential people who do not have a degree-level professional healthcare qualification; this includes family and friends, carers and support workers, and lawyers. Fourth, there is an ongoing debate about whether the patient is a team member.

This page and category of posts will consider everyone from the professionals in the team to the volunteer who brings newspapers to patients on the ward, in an out-patient clinic, or attending a day centre, and the patients and the friends and relations.

What is your contribution or role?

Teams share professional expertise, and often, other members will acquire knowledge or skills usually held by your profession. This means that, in your absence, the team can continue functioning, albeit at a slightly lower level.  Over time, the additional shared knowledge will only remain sufficient with a professional maintaining it.

The issue is identifying the knowledge, skills, and other assets contributed to team function by each profession (including all those mentioned earlier). It is more than what you do with patients. For example, a speech and language therapist will ensure that all team members know how communication can be affected by disease, how to detect communication problems, and how to communicate with affected people.

Each profession will influence the team in many ways, not only by sharing their knowledge. They will alter the team’s attitudes, relative priorities, focus of attention, ways of approaching clinical problems, etc.

The posts in this category should explore what someone involved in team rehabilitation considers they add to a team’s function.

Rehabilitation team membership and function.

At first glance, one might determine a team member’s contribution by removing them and seeing the change in function. This approach would fail for two reasons. Practically, it is not easy to measure a team’s functional output. One can study interpersonal relationships and other aspects of working together, but measuring the actual effects would be challenging. Further, the impact of removing one contributing profession would be difficult to detect.

Second, in a well-functioning team, members share much professional knowledge and skills, so the expertise contributed will remain in the group, possibly for a year or longer. The team’s ability to analyse and manage the more complex issues associated with the missing profession may be reduced, but this will not be easy to detect. The team is a system, and one characteristic of any system is resilience, the ability to continue functioning when one part of the system is damaged or lost.

Everyday experience in healthcare illustrates this. The inpatient ward functions well for hours or days over a weekend without some team members, such as therapists (at least three professions) and doctors. A hospital’s finance director can be on holiday for two weeks without significant ill-effect.

Therefore, a better way to consider team membership is to identify the knowledge and skills needed to address at least 80% of all issues the team can expect to see in their anticipated caseload. This shows that team membership is determined by the patients’ needs, not some external recommendation.

The question of team membership can be reformulated into two questions:

  • What issues will our patients present to us
  • What expert knowledge and skills will we need to resolve the issues
  • Which profession(s) possess the requisite knowledge and skills?

The profession may also contribute other expertise not directly related to the needs of individual patients, as Harriet Peel illustrates in her post on speech and language therapists.

Your post on your profession.

Teams vary in workload, the professions contributing, and their clinical approach to patients, even when seeing similar patients. Consequently, people will likely have different perspectives on what their job contributes to a team’s function. I hope you will add your view, perhaps adding to or challenging what a professional colleague has written. Alternatively, you may work in a different type of team.

I have several roles, all aimed at helping you:

  • Offering advice on any aspect of writing
  • Checking the text adheres to our values and principles 
  • Editing the contribution for grammar, clarity, etc
  • Writing an introductory summary
  • Asking you to review the final version before publication
  • Contacting you about any subsequent comments

It is your post; I want to improve it, retaining all your ideas and opinions. It will have your name unless you request it is not published.

Conclusion

You likely have views about other professions and what they add, and your ideas are different from those of people from that profession. The same will be true of your work. This series hopes to stimulate discussion, improving team functioning by reducing misunderstandings and making expectations more appropriate. Whatever your role within a rehabilitation service – manager, administrator, healthcare professional, support worker, family member, lawyer, friend, patient or any other

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