Interprofessional Collaborative Working — Serious Case Review (SCR)

This paper examines the personal, social and professional issues of the Interprofessional team in the light of serious case review of Daniel Pelka.

Introduction

According to Koubel and Bungay (2015), the most significant development in health and social care model is that it has moved away from traditional professionalism wisdom towards the patient centre care, in which healthcare professionals need to understand requirements, rights and wishes of the person who is the user of service provided by health and social care. Moreover, it is not a matter of choice; NHS has clearly defined the rights of service user in terms of involvement in planning and provision of services to integrate the need and requirement of patients along with their families and carers for collaborative service provision.

In today’s world, to manage the complex health needs of patients, Interprofessional collaboration is fundamental to address heath issues and provide patient-based care. Moreover, Interprofessional team is made up of professionals with different occupational and professional expertise, knowledge, skills and methods in order to provide high-quality care for individualized patients (Goldschmied and McClimens, 2015).

Interprofessional collaborative approach

Interprofessional collaborative approach is useful to share knowledge and expertise as well as a common goal of providing quality health care through combining resources. The key factors include in Interprofessional collaborative working are communication, responsibility, coordination, accountability and decision-making to deliver the synergies through group knowledge and expertise (Meads et al., 2014).

Carnwell and Buchanan (2016) added that the patient-centre model of care can helpful to address the problem of service care. This approach gives more freedom so patients decide what kind of services required. The principle of collaborative care is based on improving quality of care, access and safety of care, increase coordination as well as reduce burnout in the profession.

According to recommendations made by ‘Quality of Health Care in the US’, it is suggested that healthcare representatives working in Interprofessional team can address the challenges need of patients. Therefore, this mandatory clause has highlighted the need for Interprofessional collaboration for effective communication and quality of service delivery. Interprofessional is a group of individuals from various disciplines. These individuals work and communicate with each other through providing knowledge and support to each other (Koubel and Bungay, 2015).

Carnwell and Buchanan (2014) mentioned that interprofessional collaboration is known as a ‘partnership with the healthcare provider teams as well as client using coordinated and collaborative approach to resolving the social and health challenges through shared decision-making.

At last, not least, Interprofessional team shares common, blending with different healthcare professional culture as well as interaction among various departments to provide quality health service.

According to World Health Organisation (WHO), to overcome the challenges of healthcare, it is important that collaborative working must be used by health care sector. Role of nurse is to promote and provide care which put people first and at the centre of service delivery. These people involve the service user, patients, and their families along with service care provider in order to help them to make decisions about care and treatment (Willumsen, 2016).

According to the Royal College of Nursing, there is strong agreement on that person centre care equates the high-quality health care. The involvement of service user in order to develop the principle shows that they want to receive safe and effective person centre care. Nevertheless, Daniel suffers continuous abuse and neglect for a long period before his death in 2012. On several occasion, social workers fail to identify the need for continued intervention. Nurses could have identified the issue in much efficient manner to highlight the emotional and continuous neglect in the case of Daniel (Ryan and Hassell, 2015).

Inter-professional working environment

Koubel and Bungay (2015) explained that in order to deliver effective person centre care nurses need to work as team and promote philosophy person-centre behaviour with the team. In delivering the quality of services nurses are usually inconsistent contacts with patients. If there are any changes in the patient conditions these are first observed by a nurse and consequently require clinical decisions and this make nurse role even more important.

Nurses are close to providing the health care rather planning and managing the health care environment. The large number of activities carried by nurses gives them greater autonomy in complex decision-making environment.

Moreover, despite number of domestic violence incidents over the course of four years, professional were failed to investigate the impact of domestic violence on Daniel. In addition, school staff ignored the multiple injuries along with community paediatrician failure to address the health issue with Daniel (Barrett, Sellman and Thomas, 2015).

Consequently, it provides the sense that working and collaborative environment among the health professional has blurred boundaries which have damage the inter-professional working environment (Willumsen, 2016).

According to Crawford (2014), the decision taken by a nurse is usually in complex business environment along with collaboration in a diverse team. In addition to that nurse has to deliver the care according to need of customers. For example, in case of Daniel, school nurse has to make a decision about weight loss or unexplained injuries. But all the warnings were ignored over the long course of the period.

Therefore, there is a greater need for clinical decision making in light guidelines, standards as well as benchmark for effective people centre care service. Systems associated with nursing delivery of service continue to evolve over the time. These systems and processes are influenced by changing need of the customer as service delivery methods. Nevertheless, the fundamental focus is delivery patient-centred service (Meads et al., 2015).

Ryan and Hassell (2015) mentioned that nurse should play an important role in terms of delivery of service to meet patient needs. There was continuous neglect in case Daniel and on several occasions missed opportunities has raised number of questions on art of health care provider. Nurse can play an important role as it is the first point of contact with patients.

Social, professional and personal issues

Nevertheless, these collaborative efforts have resulted in social, professional and personal issues. Cultural issue remains a fundamental social problem in Interprofessional team working. Health care professionals have different values and beliefs, attitude, customs as well as behaviours. Healthcare industry has gender and class issues which undermine the difference in society (Sheehan, Robertson and Ormond, 2016).

In case of Daniel, language barrier was one of the major concerns in effective delivery of service. As explained in the serious case review, Daniel English language skills were limited. The social worker and member of interdisciplinary team were unable to communicate effectively. Therefore, problem was remained un-notice which resulted in failure of system.

Hall (2016) added that another issue is culture of institutional to support the collaborative working practice. Interdisciplinary collaboration is based on effective teamwork and must be supported by the leadership and supportive environment. The social difference is major hurdle in collaborative working approach. The role culture is health care system has created the difference among the Interprofessional team itself.

The professional problems has increased because of diverse member of a collaborative team has increased the complexity of the team along with delivery of patient based service care. The lack of integration has resulted in the communication gap (Crow, Smith and Jones, 2015).

As evident from the case of Daniel, communication problem was a fundamental factor of concern. The incident happens because of communication gap and style among the team members. The school staffs fail to elaborate the health problem and community paediatrician was unable to identify continuous emotional abuse and neglect (Salhania and Coulter, 2016).

Carnwell and Buchanan (2014) explored that another personal issue in effective delivery of services is knowledge, expertise and understanding of the team member. The possible lack of expertise or expertise knowledge of health care professional is a prominent factor. The team fail to ignore the cultural difference as well as value and believe in case Daniel case. The health care team fail to understand the cultural and did not pursue the Daniel case on value and belief.

The fundamental factor as evident from the case was the cultural barrier.  The family of Daniel moved from Poland and, therefore, there was a cultural problem evident from the scenario. When talked to the mother of Daniel, she lied to the social worker and health care professional on different occasions. There was a failure of the different member of the team as they trust the victim mother’s because of culture in UK and did not pursue the direct interview with the patient (Ryan and Hassell, 2015).

Goldschmied and McClimens (2015) explained that another important issue to address in collaborative teamwork is a societal expectation. School failed to act on unexplained injuries, failure of health care professional to identifying the need for continuous intervention, as well as paediatrician failure, was on the part of societal failure of because of the general expectation.

The personal issue involves with community-based interprofessional team which is composed of nurses, occupational therapist as well as physiotherapists. The four fundamental factors which have resulted in poor performance of community-based team is because of practice and training, status and pay, difference in education as well as various philosophies and employees background (Seden and Reynolds, 2013).

Goldschmied and McClimens (2015) studied that staff in community-based team has maintained strong boundaries which have resulted in poor delivery of services. The fundamental principle, in order to provide high-quality services, involves alignment of needs of patient and values.

Collaborative working team foster families and support patients as well as effective decision-making to improve the quality of services. The social workers were unable to identify the impact of domestic violence on Daniel which may be because of lack of training or education of health care worker (Barrett, Sellman and Thomas, 2015).

The success implementation of interprofessional collaborative requires training as well as a supportive environment through effective leadership. Member of team needs to share a common goal and vision of clear communication to successfully achieve the objectives and provide patient centre care.

Crow, Smith and Jones (2015) discussed that team continue evolution process in the healthcare system and its composition is based on the client and environment in which team is working. Interdisciplinary team is composed of nurses, social workers, psychologist, nurse practitioner, pharmacist and many other practitioners.

To promote effective collaborative environment, health care professionals must be must have opportunities to learn from success and failure. In the case of Daniel social worker, school staff as well as paediatrics must learn from their mistakes.

Koubel and Bungay (2013) highlighted that an important factor to consider is collaboration of multi-agencies in provision of services. The benefits achieved from collaborative multi-agencies involve improving quality of health care system as well as it provides the sense of responsibility to address the problems of the local community. Collaborative team working can benefit from through using up-to-date toll and information system to support the effective working of the team.

The professional in health care industry have the major difference because of allegiances as well as grouping. The role of the professional organisation is to support practitioners to improve standards of health care. Moreover, team can only manage through effective leadership in accurate working environment. The social factor such as wiliness to collaborate, attitude of the team as well as trust among the team members are the major milestone among the team members (Seden and Reynolds, 2015).

According to Health and Association Care Act (2008), care quality commission in order to decide with requirement of service user as well as carer to tackle the problem. Nevertheless, in response to the need for collaboration care quality commission has published ‘Voices into Action’, as detailed involvement strategy. The leadership is fundamental highlight to get all stakeholders on board along with the dedication of resources.

Interprofessional team working need dedicated professionals through formal as well as informal involvement in order to deliver the quality care support. There are number of social problems such as gender and pay gap, cultural problem because of diversity of professional problems because of the role culture in the health care. The engagement of multiple stakeholders is fundamental in order to deliver effective services (Bernan, 2015).

Ryan and Hassell (2012) explained that the factors which contribute to a successful team working are communication and leadership role in alignment with goals and vision. The clear definition of roles and responsibilities in health care environment and setting is very important. In order to effective deliver the results; health care professional must understand the role and accountability in order to effectively deliver the service.

There might need of additional resources because it difficult for one professional team to provide all the service care needed. Another important factor is educating the health care professional for which will enable them to improve the social and professional difference.

This will increase the mutual respect through defining roles and responsibilities to build a relationship as well as reduce the prejudice. Moreover, all professionals must stick to the code of conduct and this should not a problem to overcome the issue (Seden and Reynolds, 2013).

Salhania and Coulter (2015) emphasised that communication is key success factor in order to achieve the desired outcome. The communication gap is evident in the case of Daniel as school staff and paediatrician were unable to discuss the issue with them. The social workers, school staff and community paediatric were unable to share the information on the continuous abuse and neglect of over the long period.

In order to receive the successful overcome from the scenario, important listening skills as well as interpretation of those skills without any confusion is important to deliver the desired results. There are many reasons professional do not listen to problems and one reason that commonly viewed as source of the problem is conflicting among the team member and lack of understanding among each other (Seden and Reynolds, 2013).

When there breakdown in communication then system will not able to deliver effective results. Moreover, interprofessional education for collaborative patient approach can increase the success of collaborative practices. In the diagram below, the two circles of activities include practice and education. Education is useful in terms of health care professional learning capacity to become a successful and competent collaborative practitioner. (Sheehan, Robertson and Ormond, 2007)

Willumsen (2016) described that leadership plays an important role in the success of interprofessional collaborations. It is completely different as compared to traditional organisational leadership. The leadership focus in the collaborative process to pull the different process, as well as leadership in health care does not have formal authority. Therefore, this makes the leadership difficult process as professional with a diverse background and process are attached team.

The focus of collaborative leadership is to promote and safeguard the process of collaborative leadership. Collaborative leadership is about keeping all stakeholders on board during the period of frustration as well as acknowledge the success achieved by the team. The lack of leadership is evident in the case of Daniel because lack of collaborative leadership support has resulted in failure of identification and reporting of continuous neglect in the case of Daniel (Goldschmied and McClimens, 2015).

Conclusion

The patient-centred care approach has become fundamental for a reason. First, NHS has made it compulsory to involve the user of care service in planning and development of health services. Secondly, increasing cost and limitation of resources has an increasing demand for interprofessional teamwork.

Nonetheless, their social, personal and professional problem exist which impact the success of the team. The diverse background of the team, gender and class issue, pay matter, the role culture, as well as a lack of individual motivation, has blurred the service boundaries to deliver effective service.

At last, not least, effective communication, leadership and interprofessional education can fill the gap and deliver high-quality patient-focus care.

 

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